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tv   Morning Express With Robin Meade  HLN  September 29, 2009 6:00am-10:00am EDT

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members expected to continue an amendment to the public option. the committee democracy for america released an ad today criticizing senator max baucus for not including a public option in his version of the public reform bill. .
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>> senator baucus, when you oppose giving families like mine and public option, i have to ask," whose side are you on?" >> for more information on health care, you can go on line to the health care hub. c-span.org/healthcare. host: caller >> the head of the world bank, robert zoellick is next.
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the health care debate continues at 10:00 eastern, live, when the senate finance committee meets to work on their version of the bill. >> cspan supreme court week is one week away. it will feature personal interviews with the currently serving and retired supreme court justices. get an insider's view of the people and places that make up the nation's highest court. >> why is it that we have an elegant, astonishingly beautiful, imposing an impressive structure. it is to remind us that we have an important function. and to remind the public when it sees the building of the importance and the centrality of the law. >> supreme court will start sunday, october 4, on c-span. to complement our original
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production, we all for teachers or resources. that is at cspan classroom.org. >> this is from the johns hopkins university school of advanced international studies. ns hopkins school of the advanced international studies. i am a professor here and the director of the international development program and we're honored to be able to host robert zoellick for a major address. i am happy to be able to introduce bob because we're old friends. we met in 1989 when bob was the counselor at the state department and i was working on the policy planning staff. he had just come over from the treasury with james baker.
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i remember being on a long plane flights with him. the rest of the staff have been talking and drinking and sleeping, and bob would be off in a corner with a briefing book, working apparently without sleep to get the secretary ready for his meetings. i think that suggests the degree to which he has been struck his entire career a dedicated public servant both in the united states government and now for an international organization. his background has prepared an excellently forest current position that it occupies. he was educated and has a lot degree from harvard law school and a master's from kennedy school. he has worked at the treasury. he worked on the accords with secretary baker in the 1980's. he was executive vice president
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of fannie mae and was the u.s. trade representative and then went over to be deputy secretary of state under conte rice. -- under condi rice. he has been the president of the world bank. in that capacity, he has been dealing with quite a number of extremely important issues -- the global " financial crisis emerged charlotte ft arrived there. -- the i do not think there is a cause and effect relationship. the crisis affected the poorest of the poor disproportionately. it was something where the bank had to step up and take a great responsibility. he has moved the organization in that direction. rapidly.
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in addition to the short-term problems, there is a much longer-term set of global economic issues that has to do with the legacy of the institutions we now have to manage the global economy that were created more than 50 years ago and for a variety of reasons seem inadequate to deal with the global issues that we're facing. so bob has been very much involved in the transition from the g-7 to the g-20. with that, having come from pittsburg and now under way to the annual meetings of the imf and world bank, i am delighted to welcome you. >> thank you. [applause] it is a pleasure to be
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introduced by my good friend frank. we worked again other some 20 years ago. frank was also an expert with cameras. as we were traveling, he was the person that would fix my camera. i also want to thank the dean for offering this opportunity to be here with all of you. i know she could not be here today. she gave me the honor of speaking to one of your graduating class two springs ago. one part of my resume a left out is doug i served on the advisory council. i have had a great sense of what a superb student molbody ad faculty you have. there were shock waves that created -- sometimes old orders
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break. it can be in the power of leaders and peoples to shape the direction of change. most people assume that when " reflections on the revolution in france"was written, that a queen and king had launched a tear. this was written before the streets of paris speckled with the roar of crowds at the guillotine. 1789 was one of the great upheavals in history. burke had offered wise mornings. most had expected an english path. this can reverberate across time. when asked about the impact of the french revolution, a chinese premier allegedly replied, it is too soon to say. this is the 20th anniversary of
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the peaceful revolutions of 1989. the upheavals of that year brought an end to the cold war. they led to the opening of the berlin wall, the unification of the democratic germany, and the reunification of europe. the return of russia. these events really did feel like an end of history. as frank famously put it. the european narrative moved to new chapters. the creation of a common currency and the enlargement of a nato alliance. most eyes were focused on europe. new histories for being sketched around the world. nafta had a deeper integration of north america.
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there was an open regionalism that could connect agent with america's border in the pacific. a coalition reversed things and opened a way for a madrid conference between israel and arab states. these seeds of change were planted by leaders who saw the opportunity of midst seismic shifts. my experience than and a sense has reinforced my sense that events occur within a continuum. there exists "a partnership not only between those who are living, but between those who are living, those who are dead, and those who are to be born. outcomes are not predetermined. they depend on purposeful actions." we are living through another upheaval that is changing our world. missouri would be its
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applications for the future? it did not occur from nowhere. the last 20 years have witnessed a huge economic shift. the breakdown of the planned economies of the soviet union, the economic reforms in china and india all contributed to a world market economy that vaulted to about 5 billion people. this offers enormous opportunities. it has shapen a system force in the middle of the 20th century. some seeds of today's troubles were sowewn by the crisis. developing countries determined been never again wanted to be exposed to the tempest of globalization. many insurance themselves to
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managing exchange rates in building a huge currency reserves. summit contributed to tensions in the global economy. central banks resisted building in the new economy. most decided that asset price of bubbles were difficult to identify. they argued the damage to the real economy, jobs, savings, consumption, could be contained once bubbles burst. they turned out to be wrong. regulators were no longer grounded in reality. financial innovation and competition expanded services, including companies that work shunted aside in the past. the simple design of a rational markets. led regulators to take a holiday
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from the realities of organizational behavior, systemic risks, and the complexities of markets and humans. the actions we take today will shape future challenges. we need to learn the lessons of the past. we are often prepared to fight the crisis of the past rather than to anticipate the crises of the future. another of people will happen in your lifetimes, and it will be different from the ones we're currently experiencing. all of you have the good fortune to be able to contribute, and i hope you will choose to do so. you may be asking, how will our world be changed by this crisis? in 1944, the delegates seized a moment to shape a new global arrangement. they developed a system of rules and procedures for financial and
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commercial relations in the world economy. that world has changed enormously, not least with the transformations of 1989. it is changing yet again. we can see a potential shift in power and international corporations. the ships will depend on how parties adapt to new circumstances. in part, upon changes in who holds the technology and human resources, and what they do with it. and in part on how countries cooperate or do not. the current assumption is that the post prices political a comet will reflect the rising influence of china, probably of india, as well. the united states will see its economic power and influence
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diminished supposedly. china has responded strongly to the crisis in terms of stimulus and monetary policy. it seems to have a deep treasure chest. they have enjoyed a rapid @@@@@@!@ @ @ @ @ @ @ @ @ @ @ @å >> together, china and india account for 8.5% of world output. they and other developing countries are growing substantially more rapidly than the developing countries. and yet, china's future is not yet determined. its rapid recovery in 2000 and was fueled by an extension of credit of 26% of gdp in the first eight months of this year. this flood is no easing and authorities are likely to limit it further for fear is affect and asset prices, asset quality, and eventually general
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inflation. these risks. it will not be easy for china to shift to increasing reliance on domestic demand. it would contribute to china's goal of achieving a more harmonious society. the united states has been badly hit by the crisis. america has a culture to adapting to new circumstances and remaking itself. the future for the united states will depend on how it addresses the large deficits and overhauling the financial system to preserve innovation while adding to safety and soundness. the united states has to help people adjust to change so that it can maintain its greatest trump card -- openness to trade,
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investment, people, and ideas. people will be on the watch for signs that america's economic troubles are leading to weaken this in resources to project its interest globally and in cooperation with others. japan is the first leading power to experienced a political upheaval. the election of the democratic party of japan could create a two-party democracy for the first time. japan rose from the ashes as a trading state. it is not clear that the old export model of growth will be sustainable. they did not rely on the u.s. consumer. they will have new consumption needs. a global economy with more polls of growth that offered japan new markets. the world will be deeply interested in the shape of a
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japanese foreign policy that might assume new responsibilities. it could build on japan's experiences in development. they could deepen cooperation with others in korea and china while maintaining its global role. development opportunities in africa, latin america, and the middle east would enable japan to do well while doing good. the european union may have been slow to recognize this economic crisis was the first big test of the new york made possible by the revolution's, but it -- by the new revolutions. central and eastern economies were hit hard by the crisis. their problems or how far from over. the support offered by the
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european commission, the european investment bank, with the system from the world bank group, has been critical. they have invested in their neighbors and they are staying with them. the good strategic news is that european states, for or their debates, have recognized -- for all their debates, have recognized their independence. they did not splinter. the european central bank played a decisive role under john claude trichet. newer members may will strive to gain security. and that's tighter economic times, the european union must still face their securities. they feed worries and aggravate difficult, with their neighbors to the east, especially ukraine and russia.
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they have to offer security, even on their own continent. they have yet to cultivate a common view of their shared future. europe will also struggled with the integration of immigrants perry southeast asia may have been given a boost by the crisis. this region lies at the geographic crossroads between india and china, two rising powers. they have taken actions to deepen their actions while reaching out to others. given the rising influence of the vietnam, that has stood in sharp contrast to a decade ago. there remain questions of political transitions in countries such as thailand and malaysia. there's also a question of whether others will recognize the emerging countries.
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china seems to be doing so. the long-term impact may depend on commodities, especially oil prices, which gave very high returns. when the oil price is at $100 a barrel, these countries are strong. when it is at $30 a barrel, some are in serious trouble. they have to build an economy in a world that is struggling to reduce its reliance on fossil fuels. investors moved in and out of the asset class. will countries use these returns wisely? these are the questions for russia, countries in the gulf, and some in latin america and asia. understanding is shifting power relations is a fundamental to understanding of the future.
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the political basis for that system was forced through a shared assistance after world war i and after world war ii. the nature of the markets that connect them and the system looks out of touch. will the u.s. dollar remained the predominant reserve currency? the current system gave way in 1973 to floating rates which the dollar as the main reserve currency. it's a value strengthened during the crisis because it offered investors a safe haven. the united states is fortunate that the dollar enjoys this special status. when i work with countries struggling to finance trade deficits, i reflect on how americans did not spend a moment considering the unique in bandages of being able to print money freely.
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the histories of the war still of great campaigns and battles. the ultimate victory depended on the dry chapter about restoration of prince credit. the united states would be mistaken to take for granted the dollars place as the currency. there'll be other options to the dollar. there is every reason to believe that the year rose acceptability could grow. china is moving toward international station of its currency. they're making easy for trading partners to do business, for example, through currency swaps. china issued sovereign bonds to offshore investors. they recently announced four companies will be allowed to list their stocks in china, a
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step towards making shanghai and international finance center. one cannot imagine a new benchmark indices established in shanghai or other ports. chinese leaders will be cautious. most want to retain the control the comes from it closed capital account. markets are likely to continue to be subject to control. i expect china will be drawn out were. it will evolves into a force in financial markets. countries and markets may also experience with special drawing rights which reflect a portfolio of major currencies. the u.s. dollar is and will remain a major currency. the fortunes will depend heavily on u.s. choices. will the united states resolve
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its debt problems? can america established long- term discipline overspending? is the country restoring a healthy sector for innovation and returns without producing the same risk of big bubbles? the dollar's value will depend on the extent to which we seek a return of a private sector economy. our relations are being questioned within countries as well. central banks have played a huge role. will governments permit central banks to assume even more authority? the congress was surprised to learn the scope of the authority to create funds but assets and make transactions outside the usual process for expanding public moneys. the congress has had an uneasy relationship with banks and bankers since alexander
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hamilton. the federal reserve earned its independence over years of efforts. it should not be a surprise that american democracies is hesitating about authorizing the fed to supervise banking risk and operating monetary policy. there is a debate about the roles of the bank of england and financial-services authority. countries also face this issue with the added complexity of multiple supervisory authorities. it is a topic for others, as well. central banks performed impressively at once the full force of the credit it. there are reasonable questions about how they handled the buildup. we have yet to see whether central banks can handle the recovery without letting inflation get out of the
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control. this debate will reflect different attitudes toward banks and central banks. it will be hard to give them more authority. the treasury department will need greater authority to pull together a bevy of different regulators. the executive department and congress and the public to more directly oversee how would uses the added authority. our global trading system -- isn't keeping up with the demands of a global economy? my answer is an unequivocal no. the experiences of the 1930's have cautioned most governments not to risk a sequel. traditional trade protectionism has been a low-grade fever. the temperature is rising.
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the economy of trade is epitomized -- the only way to cover the gravitational force is by forging forward with a liberalizing trade agenda. the gains than cannot mobilize interests. the pedals are hardly moving today. moreover, with an agenda that was framed almost a decade ago, it is fast falling behind new challenges. we should get it done properly and then look ahead. a successful deal would offer new deals and demonstrate the capabilities of emerging economies to compromise. once it is achieved, we need to move quickly to a new agenda. regional agenda is part of globalization. we need rules to allow
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countries to work with others while encouraging an open regionalism. the two minutes to support -- the wto needs to support the climate agenda. wheat subsidy protectionism. we need lower barriers. the services trade much be -- must be expanded. we need more help to the poorest countries. the new agenda it needs to build on early efforts by the wto to link trade facilitation. to capitalize on lower barriers for trade, poor countries need to build bigger markets, energy, infrastructure, ready access to
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trade finance, assistance with standards, streamline customs at border proceedings. it used to take two for trucks to clear a border. now, a one-stop help establish has cut down the transfer time to two hours or less. this was forced by 44 countries at a time when power was concentrated in a small number of states. colonization was just staring. -- was just stiffing. rring. what will be the role of developing countries after the crisis? the crisis is has underscored the importance of the large emerging countries, and others as well. the world economy is being read balanced, before the industrial
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revolution. their rising economies should play a key role in the recovery. most forecasters expect demand to be tepid. many developing countries could expand demand. they have fiscal for space to borrow. they cannot get the volumes of they need without crowding out their private sectors. the middle income countries are home to 70% of the world's extreme for. the banks can assist. looking beyond, we could benefit from multiple poles of growth, with investment in infrastructure, countries in latin america could contribute to a new normal for the poor old economy. after can become part of this.
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-- africa can become part of this. coming out of the crisis, there could be a new opportunity. some chinese manufacturing firms are considering shifting their basic production to africa. we're working with africa at to develop new industrial zones that could combined training with these ventures. china's african prospects are likely to be complemented by others. brazil is interested in sharing agricultural experience. india is building railways. these are the early days of a trend that will build. we can support this development globally. we have launched a new asset management corp. to invest in banks, equity, infrastructure,
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and debt restructure. we support the development of local currency bond markets. longer-term investors now recognized the develop markets pose risk, too. they can offer good growth prospects. coming out of this crisis, we have an opportunity to reshape our policies. we have an opportunity to craft a new global system for a 21st century of responsible globalization, one that would encourage more balanced global growth, embrace the climate change, and advance opportunities for the chorus. it means expanding the benefits in competition, innovation, growth, information, and debates on ideas. it has to be inclusive and
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sustainable. it will not happen by itself. at the g-20 summit, leaders steered into an economic abyss. the danger today is a complacency. as the crisis waynes, it will be harder to press countries to cobb -- as the crisis wanes, it will be harder to press countries to cooperate. it was a good start. it will require a new level of cooperation, including a new willingness to take findings seriously. peer review would need to be peer pressure. climate change poses an early test. a clear test will be able to create incentives for developing countries to participate in low carbon growth. we will need to cut greenhouse
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gases while encouraging technological change and growth. we need a system of international political economy that reflects a new multi polarity of growth. in these two in a grade rising powers or recognizing these countries are still home to hundreds of millions of poor and they face staggering challenges. it needs to engage the support of developed countries whose public faces competitive anxieties and will feel that new powers must share responsibilities. it needs to offer a hand to the poorest and weakest countries, the 1.6 billion people still without electricity, and the bottom billion trapped in poverty. global finance in currency, the trading system, climate change, states struggling with
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conflict, and a host of other security issues -- each topic is important on its own. the countries of the poor old whenever deal effectively with this agenda unless they cooperate. it does not reflect today's realities. we need to modernize a multi laterals and in markets. the g-20 should become the premier forum for international cooperation among the advanced countries and rising powers. it cannot be a stand-alone committee. it cannot avoid the voices of the country's left outside. the g-20 should operate as a steering group. it could recognize interconnections among issues and foster points of mutual interest. it should not be bureaucratic. if given a push, the topics
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could be pursued through other negotiating groups or global institutions. the imf, the wto, financial stability board could alert countries the issues, provide analyses, build solutions, and then help execute the policy is. the international institutions must also evolves. they're voting shares should reflect the new responsibilities of emerging powers will still assuring a voice for the poor. they need the transparency to work with networks or private businesses, foundations, as well as with one another. the order was struggling to keep up with change before the crisis. today's of people has revealed the compelling needs. it is time we caught up and moved ahead.
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the question is whether the leaders can cooperate. there will be drawn to the interest of those there represent. it will be challenged to recognize and build common interests, not only case by case, but for institutions reflecting a responsible globalization. brentwood's is being overhauled before our eyes. this time, it will have more participants. it is just as necessary. the next of people is taking form now. shape it or be shaped by it. thank you. >> mr. zoellick has agreed to take a number of questions. if you have a question, please
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wait for the microphone to come around. please identify yourself briefly. the floor is open. yes. >> thank you. my name is pamela ashburn -- my name is emma ashburn. you talk about peer pressure. can you elaborate about what forms that it take? >> fred is in the audience. he may be the only person old enough to recall this. when i worked at the treasury department in the late 1980's, james baker had the idea that the g-7 and there was a need for greater cooperation and coordination, but it needed to
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start with the recognition. you have sovereign states. part of what i was talking about in the speech is, you will not change the fundamental aspect, but you can try to create a structure that puts pressure on people. the idea that we had sent in which you see evolving now was the first step would of countries to put out their own forecast of what they expect with growth. one could simply look and say, even if they're doing what they said they would do, would be the effect on the international economy? we will have and east asia that recovers more quickly? that is the starting point. on top of that, you would like to bring in a neutral player, in this case, most likely the imf. the world bank could also help. what are independent forecasts?
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and also, what is the likelihood that what you're saying is will happen? there was an early effort at this at the spring meeting we had four or five months ago because the leaders had said they wanted an early warning and monitoring system. it was indicative of the nature of the challenge. after the imf produced its early effort for a closed meeting of finance ministers, the general response was, you cannot publicize that. opposes all these troubles. that is what we have to get beyond. it gets to the point i made about the risk of complacency. everything i have said today recognizes the need to cooperate. if one points to where there are opportunities for metro corp., where you can now win-win
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interests, that is the starting point. but where there is difficulty, you can hope to push people to the messy process by compromising or adjusting. it does not mean to say they will. the other thing is that this is where the international institutions can play a role. when you. of these issues, you can -- creative minds can come up with other solutions. i will give you one to reference the speech. i was concerned early in the crisis about the affects in central and eastern europe. we work closely with some of the european institutions to try to get a greater recognition of all of europe to deal with all the banking issues in central europe. it appears to work. it was not always pleasant.
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it made some people unhappy. but it prodded the system to go forth. but you got a win-win venture. there is often more opportunities to find overlapping interests. but now and then, it is not easy for busy ministers to try to do. it's a combination of vehicles you try to use. i come back to the basics. ministers or prime ministers or presidents and chancellors will respond to their domestic public. part of this is shaping the institutions that cut across the domestic public's. this is where private businesses and others can play a role. you're shipping and overall public debate that they have to
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respond to. >> up front. >> i used to be an executive director at some years back at the bank. capitalists are always count words. one of the most important part in any development -- capitalists are always count wordwards. by lowering the capital requirements, by empowering the credit rating agencies, to put up signs that point to green valleys have stimulated and imploded risk adverse of this. it is bringing serious consequences. in the middle of the crisis, there is a tremendous role for someone to go out and be a champion of prudent risk taking again. what can the world bank do in the sense of being a champion
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for risk? if we do not have risk, we do not have the oxygen that the development needs. >> the world bank, a@@@@@@@ @ @ >> your point about risk is important for another reason. that is that it would be a tragedy if the lesson that people learn from this is how you closedown financial markets. former president zadia dogmatic -- mexico has made the point that for poor people, the problem is not too much in the lead market but not enough markets. micro finance, how can that be part of bay financial network? technology, for example,
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to increase people's access to these symptoms -- to these systems. you want to deepen the market capability in developing countries so they could have access to savings. i referenced the bond markets. if you looked at the performance of many of the countries in this crisis, very different than in the 1990's. they had more to develop markets where they could handle some of the financing issues. one of the big risks is if you borrow from a foreign currency and land in your own currency, you help manage their risks. part of it is that development. there is also the supervisory side. i think the new financial stability board that came out of the forum that is chaired by the
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bank of italy is doing a good job by identifying and some of the lessons to be learned without taking an overreach, trying to overcome the last war and be less prepared for the next crisis. this is a. the latria to touch on. when a crisis -- this is a point that i tried to touch on. there is an argument about the degree to which you have capital standards and risk-based capital standards and more of a central banking said of capital standards. you need more tier one capital, which is better equity. talk about leverage ratios. these are complex subjects. one should not assume this all went wrong because people were stupid or evil. these are not easy issues. the other. those trying to make is that --
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the other point that i was trying to make is that one of the harsh lessons is that market theory alone will not tell you how to deal with these issues unless you include organizational theory, psychology, and different disciplines. i am sure for many of the students have had this experience. you come to a university and you look for a way to put the world in a comprehensive framework. micro economics looks like a good framework. we assume perfect information and note transaction costs. those are big assumptions. part of the learning here and why think a and why sais is interesting, we at the bank participate in that and we're
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part of the financial stability board and others. i will reverse the question. it will be a challenge to some of the people sitting behind you in the room. >> thank you. a very important address. i agree that institutions and leaderships matter. i have two questions. two years before the crash, the imf was morning about the inflation. there was a forecast that the back of the attention of the u.s. fed. it is true that a collegial group of people who are respected may be able to begin to persuade their congresses to take action. it is hard for them to generate this report.
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american leadership is so important. i do think one of the anxieties that is out there for all to see is the anxiety of the american work cruces the globalization of supply of labor -- i just came back from india. lawyers, doctors say that the american middle class sees its future as being down in a madoff newseum way -- n/a malthusian way. >> i have to compliment you on under faculty. i know professor wedgwood because be used to work together at the justice department. the short answer is there is no guarantees in life. there is no formula on your point about warnings from the imf will lead people to take
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different actions. my own personal suspicion is that in the aftermath of this crisis, there will be more caution so people might actually take steps to "remedy" it said. i hope they built into a stronger system. i hope there will be lessons learned about inflation. at the end of the day, in a democracy or in non democracy, it still requires people to use judgment and trying to remedy that. the role of the imf or the world bank can be to alerts and to warn. in this case, i do not think it depended so much on the u.s. congress. it depended on some of the other u.s. institutions. so part of what i'm trying to say is that you can create
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things that can help you manage risk. they can help create institutional alerts and warnings. you clerked on the supreme court. the constitution is a framework for governing policy. one is talking about in the larger in varmint, one thing one can know for sure is one can be more alert to the interconnected these about some of the things i talked about in trade and finance. your second part, i think, is a critically important issue. i do believe that everything does not move to another country. it should be a win-win discipline. there is a tremendous amount of manufacturing capabilities. the united states has some advantages. you see an awful lot of people with potential employment.
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it is not all going to move to india. you have to help people adjust to change. i have been a long believer in the fact that this starts from everything from the types of education policies. i think when you look at how much money the united states spends on worker adjustment -- i forget if it is $21 billion. it is a huge sum of money. in my view, is not effectively deployed. i've suggested to people look it something even like a wage insurance policy which is a little different than many people from some of my political economy backgrounds. but like a earned income tax credit. you can see -- the idea of the policy is that somebody making $50,000 a year.
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they lose their job. they can get a job at $3,000 a year. but it is said they will wait to get a job at $50,000. it says to take the job at $30,000 and we will make up some percentage of the difference between $30,000.50000 dollars. is based on the logic that the best way to get trained is back at the private sector -- which make up the difference between $30,000 and $50,000. the construction of this in different ways. it is like the earned income tax credit will give additional support to people at lower incomes. it uses the notion of markets and incentives in the private sector to try to help people adjust to change. the debate -- one of the debates about health insurance is that there is a system where everything is dependent on
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health concerns linked to your job. if you lose your job, it is dramatic enough. i am a proponent of something that vote would allow people to about a tax credit and more competition to buy health care policies by removing some of the barriers at the state level. i think a lot of the social protections that have evolved in the u.s. system over time are ones that you have to adapt to create the ability to be any more flexible job and training in varmints. i say this as someone who feels that if you do not do this, you'll get these forces of anxiety trying to reduce what i think is the u.s.' s primary trump card. if you say the response is, let's put up trade barriers or let's be fearful of foreign
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investment, that is what will really close off the united states in these development possibilities. . that, but in many countries, taking kids out of school, you lose a generation.
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there have been lessons learned over the last 10 years, first with things like conditional cash transfer policies, like mexico has with the programs. but even for poor countries, there's the possibility of trying to put in relatively efficient safety nets. the program is about a half of one per sent of g.d.p. in some african programs, we do feeding programs, nutrition programs. one reason we cry to emphasize effective safety nets. this isn't just tossing money away. it's trying to use it in a way that in the heart of the crisis you don't lose funds that again will lose productive young people for a life. or for affect the healths of their mothers. these are the types of areas where you have to have effective and efficient interventions. coming out of this crisis, maybe
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coming back in a way to your first point is that there's an awful lot that one still needs to learn. this isn't a question that everybody has the answers and you can apply them. that's one of the roles that i hope interdiscipline anywhere schools can work with at the time. >> well, we're unfortunately out of time. i would like to thank bob for an extremely stimulating spe [captioning performed by national captioning institute] [captions copyright national cable satellite corp. 2009]
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[no audio] >> your calls and a look at today's headlines is next on " washington journal." the house debate begins again at 10:00 a.m., eastern. there will talk about the health care bill. -- they will talk about the health care bill. and in one hour, we will talk about iran's nuclear power.
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dr. william brodie, the president of the soft industry will look at medicare. . an amendment to create a government-run health care program, a so-called public option. we will have live coverage of the committee's work beginning at 10:00 a.m.. as we watch in the health-care
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debate unfold we want to take a look back at how the conversation has shaped up. what are your thoughts about the work done in congress, the obama administration effort and the debate outside of washington? here are the phone numbers for you -- host: here is "the new york times" this morning. making sense of the health-care debate. a showdown is how they describe it. joining us this morning is kristen jenson, a reporter with bloomberg news to help us out with the coverage. let us start with that headline, showdown day. what can we expect on the public option amendment? dogs that it is being pushed by two democrats on the committee --
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guest: it is being pushed by two democrats on the committee. the chairman has been working for months to get a bipartisan compromise and republicans are very much against the idea of a public option. if he decided to drop it altogether. he went with nonprofit cooperative that get some government seed money. he was hoping he could win republicans. so far he has not, but so far he might have olympia snowe at the edge. a lot of the progressive democrats really want is in the bill. there are 13 democrats on the committee, 10 republicans. see how the vote shakes out. host: what do you expect? can chairman baucus pull together his democratic coalition? guest: it looks like most democrats will vote for it but baucus will probably be able to defeat the amendment -- we expect him to vote against him, and we also expect senator conrad to vote against it, a democrat, a big proponent of the co-ops, and then blanche
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lincoln, democrat of arkansas, she has been fairly vocal about her concerns with the public option. really he does not need to other people to go with him but he will probably get to other democrats and will go down something like 13-10. host: will today be the end of the debate over the public option? guest: senator schumer said he expects a tough fight in the finance committee. there are plans to bring it back up to the floor. there is some support among democrats. they do have 60 votes. it will be a big fight. you can talk about the house later. host: we will keep checking in with you during this first hour of today's "washington journal" as we talk about the health care debate. the first phone call comes from thomas on the democrats' line. audit ocaller: the debate so fas
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been muddied by lies by -- from people or stupid or in the pockets of the health-care industry. death panels, all these things that are myths. but the thing i hope with the stem cell research that obama has pushed for federal funding, that the democrats can actually grow a spy because they need to stand up for the public option. the block this bill is the worst you would possibly have. -- the baucus bill is the worst to possibly have. if you keep watering it down you could end up like the stimulus bill debate, watered-down with more tax cuts and not one republican voted for it anyway. they will make it for a terrible health care bill. and then the republicans will not vote for it, and we will have a terrible reform and i would not vote for a democrat. i supported obama but obama
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should veto any bill that does not include the public option. host: mark fofrom washington, d. of a cut the debate has been low quality and almost embarrassing -- caller: the debate has been low quality and almost and harassing, with the president tried to rush through without people know what he is talking about was a bad decision. then you had the town hall meetings over the summer weather really was no plan in place. nothing was decided, but yet these poor, hersman and senators had to go out in front of the public and defend something that really didn't exist. then you have president obama doing all of the talk shows and interviews trying to push health-care reform, but even he does not know what the final package is going to look like and what the plan really is. host: let me get your reaction
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to it this ""washington times" political section -- gop approach to health care call targeted, and a large alternative plan. the republican strategy so far does not have much to show for it. but one of the most substantial republican arguments and one that shows signs of resonating came from mr. bunting, it called for the entire bill to be posted online and legislative tax for three days before the committee cast its final vote. the congressional budget office will also have to submit a full analysis of the bill requiring two weeks of work. what do you think? caller: i heard about last night and i think it is a positive sign. but even if you put the bill for three days, who is going to understand what the words mean? i think what needs to be done is this is such a big problem and such a big issue, we need to take some small, incremental steps, to fix some very serious problems in health care.
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we can pass a bill that says if you are offering insurance, you have to offer it even if people have pre-existing conditions. we can make sure that if you change jobs, your health insurance is portable. i think those things are doable and would set us on the right direction. because we do have the greatest health care here and the world as far as treatment goes, but everyone knows that access is just horrible. host: let us hear from amy from chelsea, michigan. what are your thoughts? what are your thoughts this morning? caller: a i:my, but that's ok. i would try to speak in a higher tone of boards. host: ok, scott. caller: i think the whole debate is becoming complicated unnecessarily. i don't know why. citizens can't, first of all,
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buy into the health insurance that the federal employees enjoy. for cost -- it could pay for itself. charge me a fair price and allow me to buy into the same system. i also heard the idea discussed that medicare should be opened up. i think that could be a more expensive option. but let me buy into it. i am not saying give it away. why can't i not come as a public option, buy into one of those? the president of the mayo clinic was on your program segni we could save so much money. i would just like to finish just by saying that there is a difference between pre-existing conditions, which we all seem to get, and exclusions. i never hear the politicians
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talk about the mary had of exclusions that the average -- myriad of exclusions that the average health care owner of a policy can fall victims to. costs above and beyond -- you can have the annual deductible? what do we understand? we understand annual deductible. keep it simple. we understand the co pay but not the myriad of exclusions that add to the out of pocket costs. host: the latest in the political back and forth golem -- comes from the republican national committee. here is the headline in the "congress daily." as finance market resumes, g o b -- gop aims at tax hikes. here is a web of video from the republican national committee put out yesterday.
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>> with at least eight new taxes, your health insurance costs will skyrocket. of course, it is easy to raise taxes when you live in denial about the very meaning of the world. >> here is a mandate, the government is forcing people to spend money, finding your if you don't. how is not a tax? >> that is not true. for us to say that you have got to take a responsibility to get health insurance is absolutely not a tax. >> webster's dictionary, a charge is usually of money up " -- imposed by an authority for public purposes. >> obama health care taxes, wrong for health care, wrong for our economy. host: in "the new york times" this morning the report that within hours of the web video coming out the democratic national committee fired off an in the message countering the republican spot. the message also noted the
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american medical association's support of the health care legislation asking, what doctors support reform that would institute a huge new taxes on them? that is from "the new york times" this morning. back to kristin jenson, a reporter from bloomberg news. talk about how republicans are going about debating this legislation, both on the senate finance committee and then those numbers outside the senate finance committee who are waiting for it to come to the floor. guest: one of their main argument is this will raise your taxes. certainly there are proposals -- in the house there is a flat out surtax on income, so that certainly is a tax. and there could be arguments on other issues. if you are going to have an individual mandate that everyone will have to buy insurance and assess that as a fee, that could be called a tax. and republicans are focusing on the idea of government getting bigger. we did some polling on bloomberg
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news and we asked people, do you support this particular plank that obama is proposing, the support this? we found that overwhelmingly american supported things, even such as the employer mandate that employers have to offer insurance, but the ask them over all do you support the health care reform effort, it was very tight -- almost no difference between those who supported and didn't. we found that people weren't just suspicious of government, very worried about the deficit, spending, taxes. host: amy from chelsea, michigan. talking about how the health care debate has shaped up. caller: my primary thought is we are asking the wrong question. if we would stop asking the question how we ensure everyone and start asking, how can we become a healthier nation, i think it would be easier for people to come together and find solutions. the second point i wanted to
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make its people have a good reason to be suspicious of the cost of government-managed health care. the primary reason for that is because of administrative costs. medicare, i hear people talking about medicare having the lowest overhead and the reason for that is because medicare does not have to contract, they don't have to do negotiations. they are able to just tell people how much they are going to pay and that is how much of the providers have to accept. medicare actually has a huge administrative costs for the providers because the costs are shifted from the government to the providers and eventually back cost end up with the consumer. so health care providers are in the position -- the government during an audit of their records. the provider actually pays for all the costs around that. with private insurance is not
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that way. host: it sounds like you have experience with this. what is your profession? caller: i am registered nurse and have a master's in health- care administration and i worked in a hospital -- right now i am in a nonprofit sector but prior to that i was in utilization management and quality management in the hospital. host: what are you seeing about how doctors are making decisions about medicare? whether to take medicare or not? caller: i can't speak necessarily to physicians because i work in a hospital but i can tell you and hospital, medicare and hospitals where the majority of our expensive health care is provided are really just bedfellows. they cannot exist without a job. obviously medicare needs hospitals to be providers. because approximately 40% of the care provided in hospitals in my area of the country is medicare, hospitals can't not
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take medicare patients because they need them to match their expensive to be the to cover expenses. so, hospitals are stuck. they cannot get out underneath a contract, whether they can afford to take care about -- of those patients or not. host: you and others will be interested in our guests at 9:00 eastern time, dr. william brodie, who would this piece in friday's "the washington post." a fad for health care costs. what he is proposing is a federal reserve-type board for medicare. he is a former physician and currently president of the salk institute for biological studies in san diego. wyoming, democrats line. good morning. caller: i am just so fed up with all of these politicians. when they run to get elected, we are just really good businessmen. we can run this and do this.
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we have money for everything except health care. but yet they are putting themselves down. they are saying, we are these great people and we can run things, but when it comes to running it, they can't. don't trust the government. don't trust us? is that is what they are saying? host: richard in georgia. good morning. caller: good morning. welcome back. government option and federal health care, that is a disaster. we see what happened with medicare -- by the way, they are going to pay for the program by gutting medicare, taking $500 billion out of the program. there is no such thing as a government auction -- this is a government mandate. if you opt out of the program or refuse to go in, there are fines of up to $25,000.10 year in
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jail for not joining the program. government does not belong in health care -- they need to get out of people's lives and they need to quit coming between health care and the individual. we would be a lot better off. host: kristen johnson, let us talk about what -- medicare and what we can expect. guest: we have already seen an little bit of that. many senators are hearing from constituents who are really concerned about medicare, particularly medicare advantage, which is a subsidy for private plans. some medicare patients can go into a private plan and medicare helps with that. it is targeted for cuts in many of these bills. and senators, especially from states like florida, have many seniors worry about. bill nelson last week proposed an amendment where he wanted to restore some of that money. the problem is mac book -- max
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baucus knees to get money from somewhere. and a lot of that he says can come from cutting down on fraud and abuse but some has to come from cutting some of the programs. so far max baucus has been able to preserve the framework. they have been able to defeat some of the amendments, but it will continue to be a fight both in the senate finance panel and on the senate floor. host: "usa today" editorial argues how medicare advantage turned into a boondoggle. below that, don't penalize seniors, is the opposing view written by senator bill nelson, who represents florida with a large population of seniors. yes, the cost need to be reined in but let us do it gradually. wisconsin. democrats line. caller: good morning. a couple of weeks ago when you have the doctor from the mayo clinic, he said 65% of their
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patients were on medicare and they have no problem running their clinics and hospitals with that money. as for people paying more taxes, well, i think i would rather pay 200 or $300 for a public option plan than to pay $1,000 a month for an insurance payment that would be 12,000 or $50,000 a year. -- $12,000 or $15,000 a year. i think you would be a lot lot better off with the public option plan and $200 or $300 a month. host: from "politico" the public option may have new life. the key is momentum and they're doing every day --
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tampa, florida. mark on the republican line. caller: good morning. ok, first of all, i think our government is missing a lot of what the american people are saying. i have health care insurance. it is not good health care insurance. and it is expensive. if the government wants to step in and do something, let us to something about controlling costs. parameters for companies that allow us to be able to purchase our health care at a reasonable rate with reasonable parameters. to me, i think that is the best move in the world that they could make. you know?
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what is my company doing -- they can look at all of my medical -- where is my privacy? if the government takes it over, where is my privacy? i don't believe that they have any business in the private sector. but i do believe that something needs to be done about the outrageous costs of what we are paying. host: are you happy with your insurance? caller: not particularly. i have an annual deductible along with an 80/20 split. any kind of pre-existing condition, what they determined, it is not covered. host: taking a look back at this health care debate, what has developed over the last six- eight months -- six to eight months.
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here is president obama before a joint session of congress. then i have no interest in putting insurance companies out of business. they provide a legitimate service and employing many of our friends and neighbors. i just want to hold them accountable. [applause] the insurance reforms i all dimension would do just that. but an additional step we can take to keep insurance companies honest is by making a not-for- profit public option available and the insurance exchange. -- in insurance exchange. [applause] let me be clear.
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it would only be an option for those who don't have insurance. no one would be forced to choose it. and it would not impact those of you who already have insurance. and fact, based on the congressional budget office evidence, we believe less than 5% of americans would sign up. host: sherri in chicago joins us on independent line. what do you think of the debate? caller: truly i think it is a scam. as far as the president goes, if hindsight was 2020 he would not have brought that out. this is the worst time to bring out something like that. host: the say that? caller: because of the economy. the fact we are and recession. with no jobs. it was just bad timing on his part. and the way congress and the
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senate is going about trying to come up with something to save face is really ridiculous. i was watching the hearings the other day with senator kyl -- looks like he and baucus was going to start fighting or something. really a scam, really ridiculous and bad timing. no. two, there is a bill waiting in the senate finance committee, 1699, nothing could be done with the bill because the senate finance committee is having the hearings about health care. that bill is collecting dust. it was to expand unemployment benefits for 13 more weeks, over 400,000 people who are exhausting their unemployment benefits this month from september. the head host: 9 in a "congress failed" echoes of this. health debate for tells 2010 agenda. the long debate about health care has been that the near-term prospects for other key pieces
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of the democrats' agenda, with senators and a technology climate change, immigration, union organizing and perhaps financial reform legislation are increasingly unlikely to hit the senate floor before 2010. she mentioned kyl and exchange with the chairman of the senate finance committee. here is a little bit. >> complete your thought. then i will have to recognize another senator in deference -- to be curtis -- >> it as courteous you did not interrupt someone right in the middle of a sentence. i have not dominated this discussion. i have not filibustered in this market up. i think everything i have said has been directly on point. i am responding directly. i will try to restate the point -- >> -- >> if our object is to try to reduce the cost of health care, republicans believe we should directly target solutions to
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that. what is one of the big cost drivers? malpractice. we know that by one of the studies i cited, $100 billion a year could be saved with good medical malpractice reform. our amendments were ruled out of order trying to deal with that. but that is a target solution that would directly allow us to save money. which would, of course, make insurance less expensive and cost more affordable. there is an example of a specific republican alternative. host: under jon kyl on day three of the senate finance committee markup. day 5 is today. they will continue their work. we will have live coverage at 10:00 a.m. eastern time and 7:00 a.m. on the west coast. north carolina on the republican line. what do you think? caller: i think there should be reformed. i don't think the government should step in any more.
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i am a veteran and i see examples of it whenever i do go to the va, i am in that system and i need medicine for certain things. telling me it is bad for the liver, whatever, and then they will come back and they will say, no, actually it is too expensive and we will just not give it to you when they know i needed. ii was in the emergency room one night and there was one doctor for the entire hospital, and that is what i was coming down to. if the government takes over, that is what we are coming down to. we don't need that. we just need reform. and with all of this waste -- we don't need for the government to take over. all this hatred and calling names from the left side -- we
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need to think, elections in 2010 will come up and all these people they are calling racists and calling all of these bad names, people calling these names, the elections coming up and they will remember. sound host: like you want to see more bipartisanship? caller: that would be great. host: gwen, birmingham, alabama. caller: welcome back and congratulations. what i am saying -- why do these people calling it a government takeover? you know what? i'm so embarrassed and american that we don't have intellectual people that can read. the bible even tells you study.
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we need to get with it. stop being led around by the nose with these ideas coming from republican, blue dog democrats or whatever. read it for yourself to understand what is really going on. i live in alabama, we are not competitive here with the insurance industry. and jon kyl talking about malpractice -- did you save the doctor who planted the wrong embryo in the woman and what she and their husband had to go through? host: ok. another story in "congress daily." former lawmakers seem need for accommodation in debate. former representative lee hamilton and former senator alan since then follow the zero health-care overhaul debate. the despair that too many law makers forgot how to legislate.
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here is a quote from senator simpson, the senators who proclaimed they will never compromise on health care are totally ineffective. they think the word compromise means of whipped. they are good sub bumpers and ribbon cutters but they don't cut the mustard and get the job done. missouri, republican line, barbara. caller: i want you to know that i am totally, totally furious. over two points. number one, the boys and girls playing around in the house of representatives and senate, a wonder if they know how stupid may look to us. we have simple answers to this -- not lines between states and budget and knock down lines between states and tort reform this year -- we can knock down the lines in the state's and
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tort reform. we have troops in iraq and afghanistan. we are settlin -- sitting and twiddling thumbs. if one other boy or girl is killed in afghanistan before they get off their duffs and make a decision, i personally will soon. i don't know who, i will. i am 75 years old and i am sick of all of this. host: kristin jenson from bloomberg has been covering the debate. she joins us to help us with the conversation. this is the inside the front page of "the washington times." swing vote spotlight. showing senator blanche lincoln. why should our viewers watch out for her? guest: she has been one of the democrats critical of the public option. her state is obviously republican-leaning. she is worried about her
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reelection chances and trying to represent her constituents, who are more conservative. it she is someone who is really going to be a swing vote, not only the senate finance panel but also the senate as a whole. i mentioned earlier, there are 60 votes now that senator kennedy has been replaced. the progressives really want a public option. some of the conservatives just would not vote for one in the democratic party and they will probably need 60 votes in the normal process so it makes blanche lincoln very import. on the other side there is columbia and -- olympia snowe, republican of maine and is more toward the center of politics and some of the democrats think they might be able to get on board. those two women on the senate finance panel will be and pour in to watch everything they say this week. host: as we go forward to the
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floor, what is the timeline completing the legislation and bringing it to the floor? guest: excellent question. max baucus was convinced they could finish a three days last week and was bowled over. democrats want to get it done as soon as possible because they are coming against a deadline. if they are not going to use the normal 60-vote process and go to a different process, known as reconciliation, it is really only supposed to be used for budget bills. you can pass a bill with a simple majority. it is something that sounds very good to democrats. the problem is in there are many restrictions on the types of things that can go into this bill, procedures with which it can be passed. so it has to be more scaled- back and a kind of has been start over again to get through the process. they have been thinking about this all along and there are plans, if they need to take this
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route. but they really want senate finance to wrap up its work so they can get to the gold. that is really in the next couple of weeks and democrats are pushing for this to be done as soon as possible host: your reaction to the huffington post this morning headline -- leading dem plans to blow of deal with big farmers. senate democratic leader plan to blow up the deal reached between white house -- introducing an amendment on the floor to allow prescription drugs to be reimport from canada. north dakota senator byron dorgan is not a party of the bargain struck between the obama administration, senator max baucus and the drug industry. hguest: we saw the first test in the senate finance panel last week. bill nelson offered an amendment that would have essentially torpedoed the deal and change
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the requirement of rebates for drug makers. max baucus was able to fend back off getting a support of two other democrats. in this case it was bob menendez of new jersey and tom carver from delaware, both with big drug makers and their states. they joined to defeat this, saying if we blow of this deal with the drug makers, it will make everything harder. because the drug makers have gotten on board with this. they actually ran an error -- a multimillion-dollar ad campaign to support reform. on the other side you have byron dorgan and other democrats saying we were not party to this bill, this is not a way to hold down costs and we want to make changes. host: anne on the independent line from michigan. help me with the name of your town. go ahead. caller: when i was watching the
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markup all of last week, well, first of all, i have been on disability 2000 cents and medicare since 2002. i was watching and i saw my senator, debbie stabenow, was kind of sticking up for everybody. i gave her a call and complimented her on it. i told them -- i did not tell them the whole story but i had gone on disability for two mental illnesses and in 2007 i got breast cancer. i went through this thing with my part d plan.
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i did not get part c because i thought it would bankrupt medicare. the kind of forced us to get d because they said it will be reduced by don't get it. first time i paid, i think, 5650, and the next year, 5750, and the last year i had it was 9650 out of a $911 check. what happened to me yesterday -- the staff was explaining or markup that if a person was medical -- eligible for medicare, that day -- they can get generics for $1 and the non-
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generic for $3. i got something in the mail yesterday that said that i no longer qualify -- why my circumstances have not changed. they will take me off the program. medicare was paying my benefits and i was getting these reduced drug prices. host: let me jump in. what would you like to see happen? caller: i would like to see the people on part c able to stay, but no more people be able to get on part c -- and i'm going to call the senator's office again today. i would like than to treat people fairly because my
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circumstances have not changed and my check now is $1,100 but i will not be able to pay for all of these medicines and bills. host: as for the phone call. don from anaheim, california. caller: a couple of questions and really quick points. i want somebody to explain why insurance companies need to be involved anyway, they don't have anything to do with madison -- medicine. and how much money would you say if insurance companies would not be involved. and i wanted to say that hearing people and politicians saying that it is complicated. it is not complicated.
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single payer, medicare for all. if you do not want to cut medicare, call it magic -- call it american plan. host: some other news. the front page of ""washington times" with the headline, the former president of pakistan says that the afghan debate shows a week united states. in an interview with "the "washington times," the former leader said, asked if the prolonged debate over sending more forces to again as they might be seen as weak -- this vacillation and lack of commitment and talking to much about casualties, it shows weakness and resolved. that is open "the washington times" this morning. "the new york times" this morning and several other papers this morning have stories about iran testing --ut iran policy secret nuclear plants and
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testing some of its missiles yesterday. in nuclear debate -- is iran designing warheads? there is continuing debate among american, european and israeli spies about a separate component of the iranian program, contestant -- clandestine efforts to design a nuclear warhead. they believe iran has started these weapons as asian efforts which would mark a final step in building a nuclear weapon. the germans say they believe that the weapons work was never halted. the french have strongly suggested that independent international inspectors have more information about the weapons work than they have made public. in closed-door discussions american spy agency stood firm in their conclusion that while the grant ultimately they want a bomb, but country halted work on weapons design in 2003 and probably has not started that effort, a judgment first made public in a 2007 national intelligence estimate. westminster, california.
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john on the republican line. what do you think? caller: i think there should the public option. without that, there will not be any competition to rein in the exorbitant fees charged by insurance companies. four times more for the same medication you get in canada or great britain. we are subsidizing and not getting the benefit. host: you can find us on twitter.com pared your thoughts about how the health care debate has unfolded. the independent line. caller: i would like to make a
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couple of comments if you give me the time. when you call it a health care debate, you have any number of people up there who are telling very slanted sides of the story. there is a fellow that you have on frilly -- fairly frequently, morici from the university of maryland, probably the only one who gives the picture from a centrist stand, recognizing all sides of the story. he is always very interesting to listen to. he presents a basically balanced situation. all of the people you have on, all of the politicians and everybody else, are telling half truths, one side or the other. it slants everything. it really becomes like a collegiate debate rather than a really intelligent discussion. there is a really simple
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solution to the entire health care problem, and that is to stop the inequality of the fact that individual employees, self- employed people don't have tax deductions for their health insurance benefits. billions of dollars are handed out tax-free to employers. it represents tremendous inequality of the taxation system and would probably cover threefold any health care cost of any program. host: did you follow the debate over the summer when there were several town hall meetings? did you attend one or watch one? caller: there really can't watch talking heads on television with any decency. because as i say, they are all slanting the stores that to watch any talking had program is
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very difficult thing to do. host: what the jamaica of constituents confronting members of congress about this legislation and some of the heated exchanges? caller: i think a heated exchanges are deserved -- although it is impolite to call politicians liars' -- they really are, because they present such a slanted stories, whatever their side may be, that they are leaving out all the important details. host: here is a little bit from the town hall meeting from rep -- with representative barney frank. >> i am wondering can be pledged all of us here tonight that if a new government single payer system is this the to the that you would pop out of your cadillac insurance and into the same one that you would be forced to take? [applause]
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>> as i said before, first, unfortunately there will not be a government single payer. i wish there would be, and i would join it. apparently i was not clear when i said that -- i am just curious. you really think that advances your argument? i thought you were thoughtful people here wanting to lead the conversation. i am really disappointed at the level of response. >> we are disappointed in you, sir. >> i hope but not on the same grounds. i'm trying to respond to your question. host: representative barney frank trying to hold a town hall meeting about the health care legislation. here is a star in " the new york times." abortion fight adds to the debate. strict ad -- aid ban sought. the measure is favored by moderate democrats in a test for obama. and below that, another health
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care piece -- health-care overhaul stirs states' rights claims. in more than of the oven -- dozens statehouses in the country, is small but growing group of lawmakers is pressing for state constitutional amendment that would outlaw the crucial element of the health care plans under discussion. the requirement that nearly everyone by insurance or pay a penalty. opponents of the measures and some constitutional scholars say the proposals are mostly symbolic, intended to send a message of political protest and have little chance exceeding in court over the long run, but they acknowledge that the measures could create legal collisions that could be both expensive and cause delays and health care changes and could be a rallying point for opponents. tennessee, republican line. debri joins us. caller: i am calling about the health care debate. several things that went to mention. there is a segment of the
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population that gets illegally terminated when across states. they hide the information -- coverage will not be offered for weeks and then offered at $979 a month. my husband works in a steel factory for 33 years. he was in middle management. he was not protected by a union. even though the union tried to petition to get him back. he was illegally terminated in may of 2007. at this same time, publicly traded corporation was trading millions of dollars of stocks, making all kinds of money, very rich people -- you have the people at the top, vp, ceo's,
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cfo's mega millions of dollars. they sold his health care, profit sharing, and life insurance. my husband had a disability and he had type 2 diabetes. they knew he was in desperate shape. the insurance company was blue cross/blue shield of south carolina, and they owned the bristol, tenn. system. all of his information -- when it tried to get his prescription. they had been cut before he even got separation notices. they held the separation papers for 48 hours and would not give them to him. they even called the police and have him escorted. the man that terminated him was from delphi corp. through gm, there were incorrect accounting practices.
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the point is my husband worked 33 years and paid into the social security disability system but when it came time for him to drop, when he was in desperate, desperate need, they denied him. at the same time denied unemployment. there is something horribly wrong in the state of tennessee won the wealthy people who run the state -- auctioneers, they pass the laws for all of the stuff and getting very, very rich, and i'm a republican, and i -- host: sorry, have to end it here. caller: there has been a certain failure to look at the big picture. i would suggest members of congress bring in the leaders of the industrialized countries around the world that do have a
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national health care system and simply ask them one question -- and that is, why has there country not turned around and try to establish a system like we have in the united states. host: kristen jenson from bloomberg news has been following the health care debate. before we end this hourlong discussion, just quickly walked us through the time line again for this legislation in the senate's and then once it goes to the senate floor, if it were to pass, what happens? guest: obviously the senate finance panel has to finish its work. it has to happen for the senate to move forward, but also a lot of members of the house, democrats especially, are looking to the senate for some guidance. they are not sure they want to vote on something that would just get tossed out later so they went to see what the senate finance panel does.
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once it finishes, its measure has to be combined with one passed by the house committee. senate leaders will work together, and now that bill and bring it to the floor. that is the point where we may see more challenges of the things like the public option. then the senate has to vote on it and pass it. that is the question, will they be able to do with normal procedures, will the get 60 votes -- votes, or have to do it through the budget procedure? if they do, the half to combine it with the house side. the house has three different committees passing versions. the house leaders are working together to combine that into one bill which will then be voted on the house floor. we have a house bill and the senate bill. they come together in what is called the conference, house and senate lawmakers come together, they negotiate a compromise and then has to go back to each chamber for a vote, and if the vote passes then it goes to president obama for the
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signature. certainly we have a lot of steps to go. host: kristin jenson from bloomberg. we will continue to check-in would you about this piece of legislation. -- check in with you about this piece of legislation. baltimore. caller: yes, i wanted to reiterate what the republican from tennessee, the strong woman whose husband and her family was destroyed by a lot of high level politicians and high- powered individuals. three points. the first is i believe that health care reform is going through some changes very similar to the banking industry. a lot of the same principles and practices that have been in place allowing executives -- not the shareholders but the executives and the president and the officers to make these exorbitant bonuses, those principles need to be looked at
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and applied to the insurance industry across the board, number one. and i think they need to be held accountable for what they are doing to this country because they are doing the same thing the banks have done to the housing industry, point one. by second point is that i believe i am saying this correctly, that congress is not on the same plan that they are voting on. they are an elite group who is voting on something that is not going to affect them or their families. and i think this is wrong. i think if this is actually -- if they were actually going to be affected by the changes they are making they would perhaps put their heads together and make a good plan. my third point is that i believe that the country needs to embrace more alternative health care that is preventative for many diseases that people are experiencing in this
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country, that that would actually help alleviate a lot of the burden on the the health care system. host: thanks, baltimore. houston, texas. good morning. caller: how are you doing? i was calling in regards to the health-care debate. host: sure, go ahead. caller: i had listened to some of your callers calling in. they are kind of downgrading the va. i am a veteran. i think they have some of the best health care facilities across the country.
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host: houston, we have to let you go. we were having a hard time hearing you. hopefully you can call back in. karen on the republican line. are you with us? caller: i would like to follow up on the particular part of a woman calling in, how the cobra is related to when you are terminated and it is not offered four weeks after you are terminating determinative -- for weeks until after you are terminated. social security people having to retire because they are terminated. social security is now a mess. because of what corporations are being allowed to do. they are encouraged to go overseas. they are encouraged to cut health care. they are encouraged to do all of these things. these are not addressed in any
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way through any of these discussions. also, your hippa law, it prevents you getting your information when this happens to you. host: thanks. we are running out of time. thank you for all of the phone calls about the health care debate and how it shaped up. up next, a conversation about iran and china. the headline in "the baltimore sun." iran says missiles can hit any foe. we will talk with banning garrett on how china is reacting. and later we will return to health care and talk to dr. william brody of salk institute. he wrote a piece on friday, creating a medicare reserve board similar to the federal reserve. first, a news update. >> as president obama considers a strategy for the war in
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afghanistan, he meets today with nato secretary general hu said yesterday that things are going to have to change in afghanistan for the united states and its international allies to win the stalemate. the president is also meeting today with the vice president and defense secretary robert gates, this ahead of tomorrow's meeting with his national security team on afghanistan. meanwhile, missouri senator kit bond, ranking member on the senate intelligence committee, became the latest republican to call for general mcchrystal to jan awry -- testified before congress. in the philippines, two navy construction troops died in a blast, officials say was likely an attack by suspected al qaeda militants. the first american fatalities there in seven years. the fdic needs today to consider a requirement that banks prepay three years worth of premiums,
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about $36 billion. the insurance fund has paid out billions in the wake of bank failures that began in mid 2008. c-span is covering the public meeting. you can watch it later today online at c-span.org. those are some of latest headlines on c-span radio. >> c-span's supreme court week is just a week away, featuring personal interviews with each of the currently serving and retired supreme court justices. get an insider's view of the people and places that make up the nation's highest court. >> why is it that we have an elegant, astonishingly beautiful, imposing, an impressive structure? it is to remind us that we have an important function. and to the brink -- remind the public when it seized the building, of the importance and centrality of the lot. >> supreme court week, starts sunday, october 4, on c-span to.
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to complement the original production we offered teachers free resources on the judicial system, at c-span classroom.org. >> the senate finance committee is back to work today marking up its health care bill. members are expected to consider a number of amendments for the public option. live coverage beginning at 10:00 a.m. right here on "washington journal" right here on c-span and coverage all day online on c-span.org and c-span radio. .
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guest: i think it puts china in a very tough position, and that they are always a bit reluctant about sanctions and how effective it will be. on the other hand, they share the strategic goals of the allies. they find that the threat of nuclear weapons in iran is quite serious to them as well as to the united states. i think they share our goals. the problem is, how do you achieve them, and there is no unity on our side, in our own government, on how to do that. the chinese are on the reluctant side about how effective sanctions will be. host: secretary of state hillary clinton has threatened crippling sanctions. is that something that china and russia would be on board with? guest: i do not know. you could speculate, but i think it is uncertain right now
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and i am not sure they know. we are moving toward the crunch time. we will see what actually comes out of it. i am certain that russia and china will be on the soft age of it, and we will probably be on the hard edge of it. but i think something will have to be done. host: what does "crippling" mean, and if crippling sanctions were to go through, what impact would that have on china and their economy? guest: china gets something like 15% of its imported oil, which is half of the total, from iran. i do not think this is going to cripple the chinese economy. i think they can find other ways to get oil from other places. they have a very large economy, so i do not think that is the issue. in talking with chinese officials, they stress their economic interests, particularly their energy interests, with iran, are not critical.
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there will not use those to override their larger strategic gains and political concerns. i do not think they are worried that if there are tough sanctions and they will go along with them, the chinese economy is going to suffer. host: describe the relationship with china and iran. what is it like? guest: i think it is a complicated one, and going back a long time. the shah had a good relationship with them, and i think they found it useful even after the shah was overthrown. there is not a lot of empathy with the current regime. they sell a lot of goods through iran like a lot of other countries. i think they are the second- largest employer -- i think they are the second-largest importer of oil from iran, japan being
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the largest. i do not think it is a critical relationship. i think china is more important to iran than iran is to china. host: you talk to high-level chinese officials. when were you last there, and what were the conversations about? guest: we were there in august, about a month ago. on the issue of north korea nuclear weapons and iranian nuclear weapons, i was actually surprised to see how much they put them in the same category. that is to say, they are very concerned about proliferation, and they seem to be equally concerned. north korea is a lot closer, so they're concerned there is understandable. -- so their concern there is understandable.
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proliferation in the area is not so much in the interest of the chinese. they want to stop that. it is not easy with iran. if you think about the persian gulf, something like 50% of china's oil comes from the persian gulf area, from the middle east, 30% maybe from nigeria or africa. but it is the world economy that is at risk. with the united states, our dependence on oil from the persian gulf is 10% or 12%. we would not be crippled by a cut off of oil directly to us, but we all have a stake in the world economy. but prices of oil with a diminishing supplies would be crippling to everybody. it is the impact on the global economy. you do not want another global meltdown now. i think china sees this as a
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very vital strategic interest, just like we do, in the region. host: heading into talks on thursday, in your opinion, what should the united states do or say? guest: i do not consider myself an expert on this. i think it is a tough issue because first of all i think we should say what our aim is, very clearly. we need to deter the development of nuclear weapons. on the other hand, iran has security interests, concerns. so how do you try to really get to the security concerns. i have a war on either side of them with iraq and afghanistan. they feel insecure. so is it possible to meet their securities concerns, and is that enough? that is really the question. or are they determined to get
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nuclear-weapons to assert themselves as a great nation? if that is the case, there is no way to get them to give it up. that is the debate on north korea. with the north koreans developing weapons, it is a bargaining chip? so that if you give them certain things that they want, they will give them up, or are they determined to get nuclear- weapons? or there are factions within iran and north korea that would be willing to give them up if there are other concerns. host: what does all this mean for international cooperation? guest: i think we are seeing a lot of international cooperation. we should be very encouraged. if you want to take a look back, let's go back a year ago to the lehman brothers collapse. i think you had a dual tendencies. you had centrifugal forces, each
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neighbor for itself, i am going to do whatever i have to do with economic policy to minimize the damage to me and maximize my return, so to speak. if i just pursue my own narrow interests and fail to cooperate with other nations, then maybe we are going to have a meltdown. we managed to cooperate. with ireland, with the banks threatening to unravel the euro, i have seen -- i hthink we have seen remarkable cooperation. daily contact, trying to coordinate policy did very well. i think the international community rose to the level of cooperation in the g20 meetings. people forget how serious it looked a year-ago period only a year later we are in recovery,
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and that is ququite remarkable. now you are asking about nuclear-weapons. it is not clear that this is going to work through cooperation, but the cooperation itself is important. callerhost: let's get to phone s here. ohio, democrats line. good morning. caller: sir, you just brought iran's security interest. i think if any of us were in that country and we just witnessed what the u.s. did in iraq on necessarily, and what israel has done in syria, lebanon, and gaza, and israel has nuclear weapons that go undeclared, and israel refuses to sign the nonproliferation treaty, and israel bangs on the
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war drums in regard towards iran and makes unsubstantiated claims as well as people in the u.s., you would be terrified. i would be terrified. while iran signed the npt iraq signed it and then did not have nuclear-weapons. will the bush administration -- oh, bush, sorry. quite frankly, i felt like president obama was acting like bush when he made those comments about iran. we did not see anyone held accountable for any of the false intelligence. will we wait for the iaea to verify these unsubstantiated claims at this point? guest: well, first of all, there
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is no rush to a military option in this country at all. i think secretary gates and president obama have been clear that that is not at the top of the list. secondly, they are being very cautious in their intelligence assessments. "the new york times" today reports that there is still no agreement within the u.s. intelligence community that they are moving to weaponize their system in iran. they are worried about the enriched uranium processing facilities that they may or may not be building, but they are not claiming to build a weapon at this point. i do not think there is any rush to action on the military front. with israel, it is a tough question because to them is an existential threat. i think i heard two nuclear- weapons on israel would kill about 2/3 of the population, small nuclear weapons. it is an existential question.
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as far as i understand, is real definitely has nuclear-weapons, but they have had them a very long time, and it is worried about a nuclear threat to itself. it would be very hard for an israeli prime minister to say i am going to ignore the deployment of nuclear weapons by iran. there is concern in the u.s. that this could provoke israel to attacking iran. how could this play out? i do not think anyone wants to see a military option. that is not really the question. and you are right, iran has security concerns, although i do not think iran is afraid that israel out of the blue is going to attack them with newer weapons. i do not think that is a serious concern. host: let's move on to bill from connecticut. caller: if iran ever got three
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or four nuclear weapons, so what? the u.s. has 10,000 or so, and that would scare iran. the politicians and major media are using this airtran situation to cover-up who america's real enemies are, such as wall street, large banks, the major media, and politicians. all empires that try to attack other countries have failed from the romans on. the politicians are turning this country into a bankrupt banana republic. thank you. guest: on the question of the number of nuclear weapons, iran and what kind of threat that is, you are certainly right that the u.s. has thousands of warheads, as do the russians, and there are other nuclear powers with hundreds. i think proliferation is the issue. there is real concern of what would happen if there are confirmed deployed iranian nuclear weapons. what would saudi arabia do,
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egypt, turkey. i think there is the possibility of 30 or 40 nuclear states around the world. unleashing that is the concern. if iran attacked iraq or some other state, it might feel it could hide behind a nuclear deterrent rather than respond, face a response by the united states. for example, if yugoslavia had nuclear-weapons, the u.s. would have been less likely to attack over coast of low -- over kosovo. i do not share your views with how the world is working, and i do not think anyone is trying to cover up another problem. there are too many problems.
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host: that to get your reaction to this headline in "the financial times." "the u.s. and its allies are stepping up efforts to push through sanctions that provide -- through sanctions toward companies that provide iran with insurance following the revelation that tehran is building an undeclared nuclear facility. guest: what is the question? host: what are your thoughts on that? what kind of impact could it have? guest: it is hard to know for sure, but traders in oil can get around a lot of regulations. whether china is buying gasoline on the world market and shipping it to iran. how does that all work? it is not always easy to trace
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where they are coming from or for that matter to try to actually implement and enforce sanctions on that. i am sure there is a lot of concern about how aids is going to work, but it is unclear to me -- about how it is going to work, but it is unclear how you make these things stake. host: before this news of iran broke, there were conversations between china and the united states when it comes to tires and tariffs, etc. come back and forth on that issue. does that play a role in this whole conversation about whether or not you put sanctions on iran? guest: i do not think it plays a role. my interpretation of that issue was that was a domestic problem for president obama. as i understand it, the u.s. and china worked carefully for quite some time before the sanctions were announced, the tariffs. to have a measured response on
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the chinese side, but i kind -- because i do not think the chinese leadership wants to get into a trade war. they realize they have a huge mutual interdependence ay. i think the entire issue stayed within the wto. i think they are both trying to limit, deal with the domestic audience on both sides, but appease the domestic audience as best they can, but preserve cooperation on not only this issue, the bilateral economic relationship, but on issues like iran. in some ways it shows a stronger partnership, let's try to solve this problem because we both have to deal with it, and move on. i think if anything it strengthens the u.s.-china partnership rather than undermine it.
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host: franc on the independent line, you are on with banning garrett. caller: i want to know why we are so ready to put sanctions on iran when they seem to be complying with the nuclear nonproliferation treaty. guest: i'm not sure they are, as the testing of weapons and the building of a facility -- once they had learned that the u.s. knew about this secret facility, they tried to preempt that by sending a very vague letter by the eye -- to the iaea before it was announced by president obama, and this was in violation, or appears to be in violation of their obligation and the previous disputes with the iaea seems to hinge on their violating their own agreements. i think the grounds for going after iran on this issue have to be within the international
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agreements with the non- proliferation treaty, within the commitments that iran has made that they appear to be violating. so there is a case that this has to be handled with international law and institutions, and so far i believe that is the case. host: described china's voice in these international talks in geneva on thursday. what sort of powers sway do they have in these type of talks? guest: my guess is the chinese are going to be relatively quiet. they are not going to come out and try to defend iran. they are reluctant on sanctions, and one has to remember they suffered in their minds a couple of bad centuries with foreign intervention in their country. they have always been reluctant about sanctions because they are fearful it will be imposed on them. they have always been concerned about interference in internal affairs. i used to joke with my chinese
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interlocutors who talked about peaceful coexistence. it was a concern about their internal affairs, whether it was taiwan, tibet, human rights issues. there has always been concerned about this type of intervention. on the other hand, they want to be part of the international community. in the last 25 or 30 years, they have been more and more accepting of international institutions being a part of them. they join the non-proliferation treaty, the wto, all this. china does not want to have everybody agree on sanctions and they are the only ones holding out. i do not think they would veto it. i do not think they want to be the lone voice that people point to and say you are the one preventing strong sanctions against iran. that leads to what the russians do. if the russians moved to tougher sanctions, china will have to go along with it. to answer your question
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directly, they will not be especially vocal in those talks. host: boston, democrats line, doug, good morning. caller: is it not true that under geneva conventions, if israel strikes iran without a united nations security council resolution, then they are guilty of a war crime and that the people who ordered the strike are guilty of a war crime? aren't the people in nuremberg guilty for doing exactly what israel proposes to do? thank you. guest: i am not an international law expert, so i cannot answer that question directly. i do think the israelis would be very reluctant to find themselves in that position. on the other hand, their sense of what is required to maintain their existential security interests could lead them to defy international law as you
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might see it and take the risk. they went after the syrian installation installed by the north koreans. they did not suffer any international sanctions, at least no charges of war crimes. they took out the nuclear weapons facilities in iran. that would not be their problem. the bigger problem is what happens next. host: talk about your background in asian affairs and your emphasis on china. guest: i have been going to china now virtually every year since 1981, so almost 30 years, to carry on strategic dialogue with the chinese to understand how they look at the world and key issues of foreign policy, and then help them understand better the thinking of the united states, to allow the two countries to have a better understanding of each other, and find common ground for cooperation.
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over the last 10 years, especially, it has become apparent that china is the second most important country in the world, and the u.s.-china relationship is clearly the single most important relationship between two states. certainly people at the clinic council say the u.s.-european relationship is the most important, but that is not the case. you could take the two countries, and that leads to the point where you look at the world situation. if you realize the main strategic challenges we face today are common challenges, not each other -- global economic management, failing states, specific issues like iran and north korea -- there is a whole range of issues where you cannot solve them unilaterally. secondly, you are all affected by the outcomes of how they are solved. third, you have to work together.
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we especially need to work with china if we are going to get through this century well. and the chinese want to work with us. so the possibility and the necessity are both there. so i feel my own personal work has been trying to get the countries to cooperate on these issues and build a stable, long- term partnership to do with the world situation we face and to work with other countries in what secretary clinton is now calling a multi-partner world. on the economic front in the last year, there is a pretty good record. it is interesting that nations have put long-term global comments in ahead of national interests. host: if the relationship between china and the united states is as important as you say it is, what should our viewers be watching for about what china says about the iran issue?
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guest: i think the chinese, first of all, want to cooperate with us anyway they can on these issues. whatever they do is not going to be an effort to defy the international community or try to undermine our interests or european interest. it is going to be to try to pursue their own national interest as best as it can to coincide with the international community interests. but that may make them reluctant toward certain kinds of sanctions. no one wants to sacrifice those interests if they can help them. they have domestic politics, too, domestic interest groups, big oil companies in china acting more in pressure on the government. we have this contradiction in the united states. on the one hand we want china to be democratic and pluralistic, but on the other hand we want the central government to control everybody to do what it
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says. it is a tough issue, but we will see the chinese trying to cooperate be best they can, not actively trying to undermine our interests in iran. host: will on the republican line in tennessee. what is your question for banning garrett? caller: i appreciate c-span, i appreciate mr. garrett coming on this morning. i would like to say a couple of things. i think it is very important. i do not understand why the american pentagon is not about how history does repeat itself. if you look back to world war ii, it was the germans that took over europe, and it was japan that was trying to take over the western world, america. what happened is obviously we were lucky enough to put a stop to both of them. but here we have the same
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scenario with russia now taking over europe, and they have already got their hands on it through the oil they control. and of course china has taken over for japan and is kind of pushing buttons over there for north korea. of course, russia is pushing buttons over there for iran. let me ask you, when we dropped the bomb on japan, that one bomb i believe wiped out about 75,000 people. how many people do you think are living in israel right now? i do not know, but i guarantee one nuclear bomb would be enough to eliminate the whole nation. the sad thing about it is the american morale right here is so bad and so weak from all the greed and corruption, we are in a real fix when it comes to our enemies. we had better be looking, and our nation had better ask some serious questions, as far as
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where do we stand on international defense. host: do you have any comments, mr. garrett? guest: i think we have a pretty strong defense and we are in a good position in the world relative to others, but i think also i am not clear who the enemies are that you are referring to. i do not think russia and china or other powers are enemies. efforts to kind of reconstitute their sphere of influence, they are in a 19th-century mode as far as how they look at the world. they are a little nervous, but they are not taking over europe, and their influence is rather limited. i think the real issue is how do we work with other countries to solve common problems. we are not going to repeat world war ii.
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everybody read the book, it came out badly. no one wants to repeat it. the chinese do not want to, the russians do not want to, and i am pretty hopeful that the leadership's of the world do not want to use military force against each other. i think it is not quite as grim as i think you are concerned that it is. host: what are your criticisms of china? guest: i think the chinese are trying to find their way to be a modern state, and it is hard. they have still got a very authoritarian regime. part of that is based on the fact that they have 1.3 billion people. how do you govern them, bring them into a modern society? how do you deal with your minorities, especially the weeders -- the uighurs in
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tibet, and others? in africa, their way of dealing with workers -- is the kind of thing that may have gone on with western companies 50 or 30 years ago, and now we have advanced, but the trend is to try to be part of the international community, but they have a long way to go. they have a long way to go on how to treat their own people. i think the direction is what i find hopeful, having gone there for so many years and seeing the change over time. you see a half full glass rather than a half and won. host: james, good morning. caller: i have a question regarding the politics of south asia. can you elaborate on the proposed pipeline between iran, pakistan, and india, as opposed to the one the u.s. is proposing that runs from afghanistan, to
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pakistan, to india? guest: i cannot. i do not know the details of that. i suspect it does not have anything to do with the whole question of our strategy in afghanistan. it is probably unrelated, i do not know the details of the struggle over those pipeline alternatives. host: what about china's efforts to increase its energy resources and, beyond iran, here is the headline in the "financial times," "chinese see a huge stake in global oil." guest: the problem the chinese have had to do with is their concern about energy security to come to the country. the leadership of china got snookered by the oil companies because oil is a fungible
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commodity. a couple of years ago, i talk to the leading chinese energy expert who pointed out of the oil pumped in by chinese companies, 10% went back to china, 40% was sold egypt, 20% to the united states. they did not have the refinery capacity for that kind of oil. oil companies are all there to make money, and the idea that every bit of oil they pump is going to go back to china, why would you do that unless you could sell it? the chinese government thought this was going to bring energy security to them. they are always afraid somebody is going to cut off their energy, especially with the conflict over taiwan. i think a lot of that has changed and the attorneys need to understand that what we need is a secure global system of
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energy supply for all of us. if you think about a severe cutting of 5 million or 10 million barrels a day out of 86 million punt in the world, cut off 5 million barrels of that ended is -- cut off 5 million barrels of that and it is a huge impact. we still face problems of mutual assured nuclear destruction. you could blow up the whole planet pretty much. in any case, they are still there, nuclear weapons are dangerous, and we all face destruction if we all use them. everybody has had to scramble to avoid that as we face the abyss of something worse than the depression in the 1930's. we also face mutual assured climate destruction. learning how to work together on that is important. with energy supplies, we need to make sure that everybody gets efficient energy supply on the
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one hand. that is a common problem, and the chinese are coming to understand that that is a common problem dealt with with a common solution. off the coast of somalia, they have naval ships up there. a senior official in china last month bragged or was very pleased to say they predict it -- was very pleased to say they projected 500 ships off the coast of that island. we're working very well with them because we have a common interest of keeping sea lanes open. they are not just protecting chinese ships, they are protecting everybody's ships. that sense of common interest is becoming more dominant in china and the united states, and we are working together to try to further those. host: republican line, good morning. caller: i would like to mention
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that i do not see china or russia as enemies of the united states, but i do think our self interests are different. number one, china is a large economic partner to iran, buying oil from iran, exporting a lot of goods to iran. also at the same time, as a whole, china is not allowing its currency to float in the market. they are controlling the value of their currency, so the currency is increasing in value making more expensive chinese products. they are not opening their market as they should to the united states and other nations to go there as china's middle class is rising. china needs to export less and import more. all of these are adversarial to our economic interests. i do not see they would be
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cooperating to working on sanctions with iran. guest: well, i agree with some of what you said but not quite all of it. i think they are complementary interests. we need the chinese, they need us economically, but we also need to rebalance the global economy. the chinese need to bolster not only domestic spending but domestic consumerism. the need to build a safety net of social security, education, health care. people save too much in china because they are fearful, and the whole communist system has been replaced by capitalist system, and the welfare state things have gone by the side. the government is trying to build something more modeled on the united states. there is a lot of discussion between the u.s. and china how to rebalance the economy.
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the balance is really behind the economic meltdown we have faced in the last year, and there has been a meeting of the minds on this issue between the two countries. i would not put them in opposition, that is to say we have a few were-some -- a few er-sum game here. no, they have to move in that direction, and there is a lot of dispute about the valuation of currency. it is not going to make that much different spirit is not really a critical factor here. the bigger factors of imbalance is important, and i think the governments realize that in the downplay of the issue of currency over the last year. i do see a global win-win, lose-
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lose situation between the united states and china at this time. host: we have a few more minutes with banning garrett of the atlantic council. kenny, hi. caller: i would like to make a statement about iran and russia and china as a whole. the russians are an enemy to the united states and they always will be. their interests are the only thing holding us back. china is not going to do anything that is not now are -- that is not in their own interest. what we're doing as far as our trade policies with them, because we have built them up and they are an adversary. they have yet to back us on any of these issues. i would also like to say that it
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is ironic that mr. garrett said they are modeling themselves after the united states. we have a president modeling ourselves after china, so i would just like your views on that. guest: well, i do not agree that they are an enemy, that is for certain. i think we are stuck in the same world together, and i think every country has to pursue its national interests. the question is, are our national interests in the opposition with each other? on a strategic level, we face the same challenges, starting with things like climate change and global economic management. fighting terrorism, proliferation, etc. i think we get at odds on tactical issues and on how to achieve things like non- proliferation in northeast asia
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or iran. how do you do that? we are divided internally in this country on that. the bush administration was deeply divided on how to deal with north korea, and no one really knows the answer. the russians have still not quite grasped interdependence, but they are limited. they are not an enemy of the united states. they are just the difficult partner. it is more their view of the world, not a point of independence, but the chinese get that. we are certainly not going to end up in a war with either one of them, as far as i can see. that would be the height of insanity with nothing to gain and everything to lose. host: "no details overlooked as china prepares to celebrate the anniversary of the people's republic of china." what does this mean for china and its people? guest: they had a couple of bad
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centuries and china did not do well and was a very poor country 30 years ago. they have accomplished a great deal. having been there and seen that change is just remarkable, not only the physical change. half the buildings built in the world today are built in china. but the change in their mind set, how they look at themselves and the world has changed dramatically. the communist party wants to bolster its legitimacy by displays of power and the modernized military, that it is a state that is recognized and appreciated in the rest of the world. i think this anniversary is something where they kind of look to with pride. and in the last year leading up to this, they have done well in the economic crisis. they managed and well with probably over 8% growth for the
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year. we are struggling to get back in positive territory, and they have played a real role in pulling the world out of this recession, so i think there is an understandable pride there. on the other hand, we hope it does not move toward a kind of nationalism. that is what is frightening about russia. there is a feel of wounded nationalism because of the soviet union collapsing, and prudent and medvedev have tried to restore the pride in the russian people by restoring in some way the sense of their empire and their greatness, and that is a scary kind of nationalism. host: let's get one last phone call in here. florida, clayton, republican line. caller: 100 or so years ago great britain was in afghanistan and iran and that area to refined opium, and so was china.
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now the crops sold to china seems to be oil, and iran was to have nuclear power may be for weapons, but maybe also to refine oil cheaply with cheap energy so it can cheaply refine the oil. so if iran is not allowed to use nuclear power for economic development in the world economy, the way it is right now, where would you propose -- what would you propose iran do for cash? would you propose they grow opium or what? guest: first of all, i think the iranians tried to portray the outside world and the u.s. i-- i
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think the suspicion is that is not what they are doing. particularly this one facility that they discovered is too small for nuclear power purposes. it would be more likely for nuclear-weapons, refined to a much higher grade for nuclear- weapons use. the iranians have tried to put them together and portray the west and the u.n. as trying to prevent them from developing that. i think if you look at the global warming issue, globally there is a resurging interest in nuclear power because it is clean power in that sense, as far as greenhouse gas emissions. the general global view is that development of nuclear power anywhere is not a bad thing as long as it does not lead to proliferation. so i do not think anybody is really trying to stop iran in that direction. i do not think china is getting
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refined products from iran, it is getting crude oil. in fact, iran has so poorly managed its own interest -- its own infrastructure, even though it is huge with the second- largest oil reserves in the world, it has to import gasoline because it cannot refine it. that is a problem with their own internal economic structure, which has deteriorated under its current regime. host: banning garrett, we will leave it there. thank you, sir, for your time this morning. up next, we are going to talk with dr. william brody, who wrote a piece in "the washington post" friday calling for a federal reserve tight board for medicare. first, the latest update from c-
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span radio. that is 8:45 a.m. eastern time. more on nuclear-weapons this morning from international atomic energy chief mohamed al barone day. speaking earlier at aa conferene for nuclear energy, he says a nuclear world could become a reality and the international community will have to be laying the groundwork for a global security system that does not depend on nuclear-weapons. adding that he welcomed recent moves by the u.s. and russia to resume talks on reducing their arsenals. in pakistan, intelligence officials say six taliban fighters in northwest pakistan are dead after a missile strike. u.s. drowns carried out more than 70 missile attacks in the north over the last year, but the strikes are rarely acknowledged by washington. american officials are considering intensifying the program. meanwhile, in new york today, an afghan immigrant will be arraigned in federal court on
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charges he plotted to bomb mass transit in the new york area. not jerboas ozzy has denied wrongdoing. economic -- najibullah zazi has denied wrongdoing. finally, a senate committee looks into whether congress should reregulate. senator arlen specter convenes the judiciary committee this afternoon to hear testimony on the issue. c-span crews will be covering that hearing. those are some of the headline on c-span radio. host: joining us from san diego this morning is dr. william brody, the president of the salk institute, a former physician who wrote this piece on "the washington post" friday.
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"then create an autonomous agency like the federal reserve to oversee and determine how medicare dollars should be spent." why are you proposing this idea? you call it a federal medicare reserve. guest: the basic problem is that the medicare fund is going to go bankrupt in roughly 10 to 15 years, depending on projections with the aging population. at medicare, like the rest of our health-care segment's, has not been able to control the rapid run-up in costs. there are solutions, but whenever those solutions are proposed, they get buffeted in congress because congress is not only deciding how much to spend on medicare, but they are dictating what we pay for specific procedures. so you have this hodgepodge of laws. the medicare building regulations are three times the
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size of the irs code, and if you think you have a difficult time filling out your income tax return, you should try to understand what procedures are reimbursed, how much, and how to do the coding and so forth. i have simple thoughts for complicated problems, and the symbol thought is, why don't we try to remove one element of the political buffeting by creating a quasi-independent agency like the federal reserve that could then implement on a regional basis the appropriate rules for reimbursing for medicare services. host: give us more detail about how you envision this bored working. guest: i do not have lots of specifics. this is hardly a new idea, but i do think it is timely. there has been a group called medpac, which is pointed --
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which is appointed i believe by the congress, but the recommendations when they get to the congress get subject to lobbying by all the special interest groups, from physicians, patients, to medical device, and hospitals, and get watered down. so the idea would be to have a similar body that would then look at the setting rules for reimbursements. for example, there is a threefold difference in how much it takes -- and how much it costs to take care of a medicare patient. you may have read about the study coming out of dartmouth college on medicare spending. it costs three times to take care of a mental patient in texas as it does san louis obispo, california. simply changing the rules so the -- when you spend three
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times more on the medicare patient after adjusting for age, sex, severity of illness, geographic cost, and there is no demonstrable improvement in health outcomes for that. i think just adopting some simple guidelines for reimbursement. another example is we know that a study from the national institutes of health shows that certain kinds of generic drugs perform as well or and if not better than the higher cost proprietary drugs. yet when the congress tried to implement -- excuse me, when medicare tried to implement reducing the reimbursement to the level of generics, they were caught out by lobbying by special interest groups. host: who do you envision sitting on this board? caller: i think it would be a combination of stakeholders and experts, so you would have
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economist, health-care providers, patient advocates, the kind of people you would want coming around the table. one of the difficulties we have to relate is there is no vehicle to bring, for example, providers, payers, and patients together to discuss in a common forum what the appropriate level of reimbursement would be. host: and how would this help patients and physicians, and providers? guest: you have to start back with some common -- with an overall look at the health-care system, when i call the five c's. there is a lot of focus on cost and coverage, but the other three are important equally -- that is consistency, common elements. when you rated by any study, consistency is not so good.
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the rand corporation looked at about one dozen common illnesses in about a dozen communities across the country. they found that only about half the time the patients get the right diagnosis and treatment for common illnesses for which the diagnosis and treatment is very accepted. these are noncontroversial things. this tremendous variability in the delivery and quality of care in our country -- if you come here for a heart transplantation or something sophisticated, it is the best in the world, but for common things, we do not do a very good job. we are number 32 in the world, down with coaster rica, even though we spend almost twice per capita. when you look at the system, how
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can we improve performance? but we do not have a system, we have a series of cottage industries. other countries, the health-care system is generally a government-run system, so the government can push and pull levers. i think our country this would be an unacceptable solution, so we have to find ways of managing more effectively and efficiently. it is not about rationing, it is just about providing the right care to the right patient at the right time. and i think that is best done outside the halls of congress, where it is subject to all sorts of special interest groups wanting to be sure that they get their piece of the pie. host: let's get our first phone call in here for dr. william brody. linda joins us from boston, democrats line. caller: what do you think of the medicare system that we have today? guest: it depends on your
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perspective. since i am a medicare beneficiary, i would say that most medicare beneficiaries are very happy. in fact, of all the health care consumers, if you want to use that word, medicare beneficiaries are the most satisfied with the care that they get. if on the other hand you talk to physicians and hospitals, they will tell you it is a nightmare. and many physicians are no longer taking medicare patients because the reimbursement is too low. for example, screening mammography, which is important for women over the age of 50 and particularly medicare beneficiaries co, many physicias are not regularly doing screening mammograms. there are about 10,000 different billing codes, and hospitals have to hire large numbers of people who do nothing but try to
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figure out what is allowable and what is not and how to adjudicate that. so we waste a lot of money. so i think if you say who is going to benefit and who is not going to benefit, it is a complicated mix of people. but simplifying the processes would save a lot of money without impacting the kind of care that we provide currently. in fact, i would argue we could do a better job in providing care. host: frank in ohio on the independent line, what is your question? caller: i am and 83-year-old world war ii veteran, and back in my days you had bluecross and blueshield. when you went into the hospital, all you did was report bluecross and blueshield. you either had your appendix out or prostate or this or that, the no 8 is all coded. the worst part of the coding system is i have a friend who
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works for a coating company. they have to call india to get the coding to report back to this country what the charges are, and that is outrageous. now, as a world war ii veteran, i am on 100% disability. all my medical was paid directly from the v.a. system. but now, thanks to hillary clinton, who reevaluated the welfare system in 1993, now when i go to v.a., say, for example, to get my toes trimmed because i cannot do that, they charge it to my medicare a and b, and they turned over to aarp, and have it is not paying for anything. guest: frank, i am not an expert
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on the v.a. system. i will say that the v.a. system has done an outstanding job of bringing information technology to bear on the quality of services that they provide, but i think you raised a more important point. 20 or 30 or 40 years ago, there were only half a dozen pairs that doctors and hospitals had to deal with. today i asked the chief financial officer for johns hopkins how many different payment plans they had to deal with, and they said 770, each one with their own rules, many with only paper submission of the claims, and so we are consuming a large amount of the health-care dollar in needless bureaucracy that adds very little value. and i would include it in that that is because of the complexity of medicare. it just requires these specialists, plus people from india or indiana who can help
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open mind on what is allowable and what is not. it does not need to be that way, and i think that is one area where congress and the federal government could set standards that would simplify the whole process. you might actually be able to understand your bill, which right now you need an accountant to figure it out. host: in columbia, south carolina, democrats line, michael joins us. caller: good morning, dr. brody. i just want to make a comment about the proposal you made about the federal government. i have a problem with that because i have seen this in our education system. the people who pay the most money in a district or area are the ones who get the most help. i am wondering what your thoughts are. guest: i am not sure what you meant. i understand about the level of
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bureaucracy, but -- host: i think he is referring to what you said earlier about regional responsibility, and maybe the concern that those in those regions would give preference to certain areas over other areas. does that make sense? guest: well, the whole issue is complicated. right now we have a system that rewards certain states with high medicare payments, and other states, low medicare payments, with no particular economic or medical justification for the differences. .
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which makes no sense whatsoever. host: the next phone call from miami on the republican line. jane. caller: good morning, dr. brody. i am in miami and we are high up on the list as far as the cost per patient. and it seems as though there is a lot of churning of costs in some of the states. i will talk about my mother, who lives in massachusetts, of which i have specific knowledge. it seems like she gets a lot of vigilance -- she has a lot of appointments and there is a lot of vigilance but when there is and currants of something going
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on, she is not always getting what she needs. for instance, see fell in the street in a small town in new hampshire, and she is on coumadin, and she turned around and went to a hospital the next day for treatment. she hit her head. those bills went into the federal government. i am not sure medicare should have been paying for those bills. i think perhaps it would have been the minister polity that had the whole and the sidewalk. it did in those municipalities that had the hole in the sidewalk. the medicare card seems like a debit card for people to get with payments -- quick payments. that would be one observation is perhaps medicare is paying a lot of things they should be paying for. on the other hand, she was
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having a series of small strokes and went into the doctor's office and they sent her home. this is maybe six years ago. and she actually had a larger stroke driving herself home. here was an instance where they really needed to act on her behalf to protect her and frankly everybody else on the road that day, and didn't. so i would just like to hear your thoughts on what you think of going on with the churning of expenses, the open credit-card, costs that the taxpayers are paying for essentially. guest: you sort of raise a bunch of issues. i think to address them would take a lot of time. but i think there is no question that there is churning of medicare costs, there is fraud and abuse. and i think those things are well documented and the federal
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government is working on it. i think that the complexity of the hold medicare billing code and the fact that we -- and the culture of our societies, we expect as health care consumers to get anything we want, any time at any cost. and i think that somehow we're going to have to change that mind-set. let me just cite one example, again, from dartmouth, the medical school. they looked at a cost of taking care of patients in the last six months of life. these are all patients who died, so you can't argue the treatment was one better in one place or another. they all died. and they looked at the top 77 hospitals ranked in u.s. news and world report. again, you can't argue that these were idiosyncratic community hospitals. these are the main clinics, john hopkins of the world. they look at how much it cost to take care of a patient the last
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six months of life. guess what they found? threefold difference in how much it cost to take care of a patient to basically died, the medicare patient. there was almost a fourfold difference in the number of outpatient or hospitalization visit, so there was much more churning and utilization of hospital in those places that have high cost of taking care of the patients as opposed to those places who were more efficient. that is what we need to get at. the only way i think we can get at that is for some independent commission that really has sort of the force of law to enact rules and regulations on implementation of medicare that are not subject to the political buffeting we see in the halls of congress. host: we have a tweet -- let us take the first part of that.
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doctors prefer the traditional medicare rather than all the different private insurance companies. what do you think about that? guest: it depends on which physicians you talk to and which state. because the level of reimbursement -- if the level is adequate, medicare is simpler, electronic building, and people are used to deal with it. but if you have to deal with 770 plants, some are simple and probably preferable, but the sum total of all of the different plans create enormous overhead. what we are seeing really is a number of primary care physicians who are getting out of practice. some of them are not taking medicare patients in those areas where the reimbursement is too low. not even covering their office rent. i argue we should pay primary- care physicians more, not less, because in fact it is the primary care physician who can help determine the best care for the patients, going back to the
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woman from miami whose mother had a stroke. right now we pay primary-care physicians so little they cannot afford to spend a lot of time with the patient. spending time and understanding what is going on will ultimately save a lot of money in the health care system. very controversial idea the do not saying paying the higher paid specialists but paying primary-care internist, pediatricians, general and family practitioners so they can spend time with a patient. host: here is the headline from "the baltimore sun." medical students -- primary-care isn't an option. more are looking at specialized care rather than primary care. your thoughts? >> the saying in medical scare is rogue -- you go into radiology, opthamology,
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orthopedics, dermatology, anesthesiology and dermatology because those are the high paid specialists. the problem is the average medical student is graduating with a debt load in the hundreds of thousands of dollars, double -- i think the average debt for medical student graduate now is $160,000. so they are looking at those specialties lucrative enough that will allow them to pay off their debt. one things we do a little bit but do the lot more is a debt forgiveness for those medical student to go into primary care specialties. we need people on the front line who actually know the patient longitudinal lee and can give it lies on the best way to deal with health care system and to optimize their health and safety. >host: south bend, indiana. independent line. caller: however you, sir?
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i'm a 75-year-old surgeon, i started before medicaid paid for -- i think your ideas have a lot of merit, but they don't get to the base of the problem. total transparency with an obligation to compel competition for every medical dollar spent in the united states of america. that is going to take care of a whole lot of the problem. i've had the privilege to spend time in over 60 countries -- i could tell you without question, we are really -- we suck big time, and i am sure you know that. the problem is not necessary the medicare but the ancillary aspects. whenever we let our wonderful politicians put their finger in the pot, we know what is going to happen, it is going to cost
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more. i would love to be able to leave my telephone number with somebody there so you can get ahold of me, because i think between the two of us, we can solve it pretty easily. i can diagnose a torn medial meniscus clinically 99% of the time in a patient's name and take three x-rays to make sure there is no bony involvement. but if i don't do more tests than god, jesus, moses, mohammed know about, my family could be living under a bridge. that is not acceptable. host: hang on the line. let us get to dr. brody's thoughts and we will get back to you. guest: we are over-diagnosed and testing and overspending. no question, we can do a much more effective job. i agree entirely. the difficulty is we have this system is which exist system
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that and and since incentivizes us to do more -- we have a system which incentivizes us to do more. screening mammograms. in sweden they offer screening mammograms at a very low price. how did they do that? they train a group of paramedics, under supervision of a board supervisors -- board supervised trained radiologist and i can do this that is for a fraction of the cost and the united states. in the united states, because of the intense lobbying, the only people who did that are specially trained certified radiologist. so we don't have the opportunity to provide more cost-effective studies. in japan they do colonoscopy is for a fraction of the price for oil and cancer screening. again, they have trained technicians under the supervision of a gastroenterologist. there are a lot of things we can do to reduce costs, but there is
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absolutely no incentive to reduce cost. reduce pressure -- there is pressure in congress, including my former physician group, go to congress and say you've got to have it this way and then the being the most exam -- expensive. caller: maggie and example, please? in 1982 -- may i give you an example, please? in 1982 a group got together and decided that it wanted to make sure that every patient who had an operation on a knee either had an arthrogram or an arthroscopic examination before an operation was done on a patient's knee. i had a fit. all you are going to do is cause infection in knees. arthrogram don't necessarily give you a diagnosis and why in god's name does somebody have to pay for arthroscopic exam because you have to open in the any way.
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they got it passed. why did the will pass? it all had to do with money. former organizations you belong. i'm in the same boat. i dropped out of the ama and others more years ago than we want to talk about because all they were doing was severing their own nests. that is what we are looking at. if people like you and i had a chance to give our learned opinions, if you want to call it that, we could solve this problem and no time. guest: what i am proposing is a variation, which created an independent group actually able to have some teeth in the recommendations that would do exactly what you said. look at the idiocy of the current ways we reimburse for procedures and change the rules and actually have them stick.
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a lot of people know what needs to be done, the question is getting the political will to move away from the congress so it can get them. host: let us move on to a laptop city, md. -- ellicott city, maryland. caller: have a question about costs that are not covered too often. we don't have a system, like you mentioned, it is all just piecemeal. we cannot negotiate with drug companies. roche gives their drugs away free to the swiss edison because they are a swiss companies of a can overcharge americans. so we are subsidizing other countries. you mentioned high cost verses other countries. other countries, dr. salaries are nearly what they are in america. in germany the average salary is only $87,000.
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so that the average salary is $200,000 in america, there is some of that discrepancy right there. and your opinion on medical records, electronic medical record, and standardization, how much you think that would help. guest: you raise a number of issues. one of the differences between becoming a physician in the united states and in europe, in europe, the education is free so you don't graduate from medical school with an enormous debt and that is driving, as i said earlier, driving students into higher-paying special ways -- specialties. for primary care doctors, it is probably not all that different from europe. students sang, look, i just cannot afford to go into family practice. i cannot do this.
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furthermore, a lot of the students say the way it is practiced in the united states, a stop watch, you can only spend 15 minutes with a patient, is really antithetical for why they went to medical school. there are some systems like in california and oregon and the west coast that is recruiting some of the best doctors because they can go into a practice that really gives freedom to deal with the billing and bureaucracy and focus on patient care. but that is really in the minority in the united states. that is really part of what it is driving it. you asked some other things but i will turn back to you. host: i am sorry, we lost that phone call. we will have to move on to is it on the republican line on college -- from college park, maryland. caller: i am a phd student,
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biological science. it is very acutely aware to me that the one-size-fits-all medical solution might not -- everybody has a different genetic background. different profile in east asians as and caucasians or african- americans. and having a panel decide what sort of acceptable levels for a certain drug verses another could be rife with problems. medical decisions are very personal issues. that brings us and to contact with the fact you are proposing a federal reserve board-type and today. one of the big complaints is the federal reserve board is supposed to be politically independent when in fact it is not and it is causing politically motivated bubble and
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the economy. new not think it is a very dangerous model of controlled to allow a select few of totally unaccountable people the power to make those sorts of large scale decisions? guest: i disagree with you entirely. we do need standards. when we recognize they are differences, -- right now we have no system of standards. if patients were getting great care, i would not disagree, but the fact is all the evidence we have from medicare studies to the rand corp. study is show patients are not getting the best care and oftentimes are getting terrible care. the health care statistics on the macro level document that. you cannot start by saying we have a great system. we don't have a great system. the question is, how old do we
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move away from at least on the medicare side where you got decisions that people recognize are appropriate but cannot be implemented because of the political buffeting. it is true the fed is quasi- independent, but it is subject to politics. and if you have a separate federal medicare reserve it would be subject to political buffering but it would not be elected every two years the way contract -- congress has been subject to the campaign financing that allows interest groups to lobby the congress and prevent the right things from being done. it is really about using the knowledge we already have about providing the best care and being able to implement that and we simply cannot do that today. host: who would oversee this board? guest: ultimately it has to have a relationship with either the congress and the administration and that is where the fight
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would come in if this were ever to take place. so i don't know organizationally the best way to do that. of course the fed chairman is appointed by the president and the obama administration has talked about a similar model. congress does not like that because they do not want the executive branch controlling that. but in some sense it might be a check and balance with congress appropriating the money and the executive branch providing the oversight. host: galveston, texas. the morning. caller: i would like to direct c-span viewers on mr. brody's we could begin paige, director of medtronic, international medical device company and also board of directors of ibm. this medtronic company, if you click on it -- guest: let me stop you there, i am no longer on the board of
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medtronic. caller: it is listed on the fortune 500. can you please disclose before you start shelling for privatizing? and another thing, sir, people well aware of what the fed reserve is aware of this country and i would not like what you trying to do with the federal reserve because the fed reserve pinot is no more private than federal express. i think you should explain yourself. host: go ahead, dr. broder? guest: i am on the board of a pharmaceutical company, no board is, i am not on the board of medtronic, i found the three medical device companies and i operated and trained in surgery and radiology and have taken care of patients and i am currently president of the salk institute for biological studies which is really developing those scientific breakthroughs that would lead to the cures for alzheimer's, macular degeneration, and of a chronic illnesses driving cost. yes i am conflict from every
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different perspective but i am also a health care consumer. i am not to defend or attack anyone segment. my objective is to figure out how we can provide the best care for american citizens to maximize our health and welfare and do it and make it affordable. right now we have a rising number of people who don't have insurance. my children can get in their late 20's and 30's are paranoid to change jobs because they might lose their coverage. that makes no sense. people are denied coverage for pre-existing illnesses. we have a hodgepodge yet we are spending almost twice what the next developed countries -- country spends on health care. we have a problem and we have to figure out what to do. there is no perfect solution. there is nothing we can do that will satisfy everybody and will be perfect and no health care system in the world is perfect.
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we are not going to have a socialized government-run system in the united states. our culture will not allow that and i am not advocating. all i'm saying is within the existing system there are lots of inefficiencies, whether medicare or medicaid or whether it is in the private sector. and we should do all we can to eliminate those. host: the debate that would have been at the senate finance committee, day five on health- care legislation. an amendment to create the so- called public option is expected to come up. what are your thoughts on that? guest: i am sort of not in favor of a public option, per se, if it is going to replicate medicare. the issue is creating the right incentives. if you create the right incentives, the private sector
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or the not-for-profit sector could probably work more effectively than the government sector. and i think we have seen a substantial backlash in the public, not wanting to have a public option. so i don't think politically it is a viable option. if it happens, then we better have the right safeguards to allow the public option to the right things. at least in the not-for-profit or for-profit, you have more flexibility. but you got to provide the right incentives so that, for example, if you have insurance companies, you have got to be able to take on all comers and you have to have what is called a community rating system as opposed to an individual rating system so that everybody is going to be able to purchase insurance. host: your thoughts on health care co-ops, the alternative? guest: i don't understand healthcare co-ops.
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but again, if i think it is in the private sector,. -- and i spent most of my time in the not-for-profit sector, i have more confidence and the ability of that sector to deliver cost-effective care and coverage and then i do in the public sector. host got a couple of more phone calls. kansas. good morning. caller: i found this conversation interesting. i have several ideas. one caller called in and said the government all to get together with the physicians to figure out the problems. he left out one aspect, and that is the patient. we are the ones who really know where the waste is. i am disabled. i have been for a very long time. i had almost 50 surgery spirited -- surgeries. i go to a doctor's office, he writes a script and i go down to
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get it filled and i don't know how much the prescription is costing. the last time i really got a shock, i found out it was for $700 for a tube of antibiotics. one that cost of $50 was just about effective. the other is that medicare, even if the person has the private insurance, i just had to drop it because it was getting more expensive. i just love my thought here for a second. host: go ahead, dr. brody. guest: first of all, i hope i was not misunderstood. i am advocating that patients, if you create this federal medical reserve, that the patient has to be part of the
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advice in how to effectively provide the care. i agree entirely. i think transparency and costs is critical so the patient knows what they are getting but also the options. again, we have lots of perverse incentives. yet a system where you go to the doctor, the doctor orders a prescription and neither of you are paying for it if you have full coverage by the employer or the right medicare supplementary coverage. it is light telling your child or grandchild to go to the cafeteria or chocolate store or ice cream and order anything they want and you will pay for it. we've got to change that. it is about fixing those incentives. host: fort wayne, indiana. good morning and thank you for c-span. --
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caller: good morning and thank you for c-span. why aren't the insurance companies and the free-market -- it seems like if they participate, to improve their prize, it seems like that would be a good start to put them on the market. and why are we allowing a company to monopolize a state, 80% of to 90% with 1 insurance company. i don't understand that and why aren't we allowed to shop state to state for a better policy of that payment? guest: well, the latter has to do with the fact that insurance is regulated by state, not by the federal government. you have this bizarre situation -- bizarre may be the wrong word but you have a system where it is really a state function and not a federal government function. where you cannot necessarily go
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of the state to get coverage in state unless that insurance company is authorized to do business in the state. i am not quite sure what you mean by the free-market, i think insurance companies will tell you it is a very competitive business. and one of the challenges is for a few dollars a month, patients will change insurers, so insurers are not guaranteed to have you as one of their beneficiaries for a long enough period of time that they need to do the kinds of things that will keep you healthy in the long term. the kind of screening and counseling sessions to reduce your probability of getting chronic illness like diabetes or pulmonary disease and heart disease and so forth. saying if you will not be here next month or year, it does not make any sense to invest that money. a that is again one of the challenges of the marketplace.
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host: dr. william brody, president of the salk institute. thank you, sir, for giving up very early hour in san diego. guest: you're welcome. nice to be on c-span. host: up next, wall street. the headline on business day section and "the new york times", doubt, 10,000. -- dow, 10,000. 4 >> this saturday, the meaning of
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matthew, my son's murder and a world transformed, following a taped event, the mother of matthew shepherd will take the calls live in the studio. and sunday, three hours in debt with talk radio host and town hall blogging, hugh hewitt, he is the author of 12 books "-- including, "gop, 5.0." the senate finance committee is back to work marking up its health care bill. members are expected to consider a number of amendments on the public option. live coverage beginning at 10:00 a.m. right after "washington journal" here on c-span coverage all day online on c-span.org and c-span reappeared. >> "washington journal" continues. we are back talking about the economy and what is happening on wall street.
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i sold you the business section of "the new york times." dow 10,000, creeping back yet again. and andrew ross sorkin rights -- and a flurry of big merger deals, signs of restored confidence. he writes that as a signal of confidence and that executive swagger may be returning, at two large mergers were announced monday, adding to the flurry of deals in the last month. he goes on to say taken into the context of what is a merger drought, dealmaking is still off by more than 50% from last year, the transaction suggest the most senior ranks of corporate america may have the most optimistic outlook on the economy. right thing this morning in "the new york times." in "the washington post" there is a column by jeff colgan, time to plan for the next recession. he is a senior editor at large
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for fortune magazine. we want to get your thoughts. you see signs of economic recovery? here are the phone numbers. host: a little bit from goeff colvin's piece. the end of a recession seems so close that you could almost smell it. stock market is surging, china and india -- india firing on all cylinders and no one would be surprised if in the next one of the u.s. economy shows signs of growth, too. this is exactly the wrong moment to let up on the mean and lean strategies. in fact, it's time to go third and developing a new, even tougher mind set managing for, yes, the next recession. do you think the next recession is coming or do you see signs of economic recovery?
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also the latest cover of "business week." it says why the market will keep going up. the storm has passed and the old rules of risk and reward are back. indianapolis, indiana, nancy joins us on the independent line. good morning. nancy, you need to turn the television down. i got it. -- caller: i got it. sorry. hello? the thing i'm concerned about the most is inflation because they printed too much money and the devaluation of the dollar, and the dollar essentially as not going to be the reserve currency anymore. my concern is i have been buying gold and silver, and i will not get into the stock market because i think
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eventually this economy is going to collapse. that is my opinion. we printed it way too much money, which is backed up by federal reserve notes which is backed up by nothing. and the rest of the world sees this, too. host: abuse says -- say you have not invested in the market? caller: i am buying silver and gold because if we go to another currency i will have something of value to traded in for. host: san antonio, texas. democrats line. do you see signs of economic recovery? caller: i'm a truck driver. i been all of the country. it depends on you ask. i have been in industrial parts of the country, and it really depends on who you ask. as far as myself, i really don't know, i really don't know. seeing what kind of opportunities out there, to see if the economy would pick up, it
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would pick up first with us because of the transport of goods. my answer would be, it depends on who you ask and the people around me, not at all. i am around middle-class people and the day-to-day spending as far as our citizens, i don't think that has come back. so i would have to say probably for those make a little money, yes, but as far as medical america, i could not say so. -- as far as middle america. host: closely watched index of home prices shows improvement for the six month in a row. bloomington, illinois, republican line. good morning. caller: there is another way to read those mergers, and that would be that the economy can't support the number of businesses that are existing right now, so what that seems to indicate to me at least is a harbinger of inflation.
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because as the number of businesses contract and consolidate, they are more likely to raise prices. one other thing i would like to say is not too long ago in "newsweek" there was an article about small businesses, and that article stipulated that 45% of small businesses are now unprofitable. so i don't see the economy is recovering. host: a headline in ""washington times" but the first caller referred to, dollar may not retain dominance. the world present -- world bank president warned monday with our economic powers rising quickly time is running out for the privilege role enjoyed by the american currency. florid, next. caller: the whole economy had started going to sent the 9/11 thing.
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as it spiraled down, it got worse and worse and worse, and now we are starting to look like a little bit of recovery. now we have iran with their medium-range missiles. they may not have nuclear bomb capability -- but there is no doubt that they have nucleate give ability that they can wrap it around conventional weapons and make what is called a dirty bomb. host: just want to live there but just to remind you and the viewers to turn the television down because we get feedback and it is difficult. the latest on the iran issue, it says iran pots in nuclear chief said it's a country built the newly revealed uranium enrichment facility inside a mountain and next to a military site to insure continuity of its nuclear activities in case of an attack. also the latest on the associated press, iranian
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lawmakers are warning the u.s. and other world powers against pressuring to run against its nuclear program. albuquerque, new mexico. are you seeing signs of an economic recovery? >> yes, i am, but i don't trust it. i believe they are still cheating and lying. i am 80 years old. what they are doing is bundling them and selling them -- it is crooked. what we need now is a public option because the insurance companies are all colluding. it is no law that says they can't compare notes. they are colluding against us and we need a public option to give them -- keep them honest. host: joining us on the phone
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this morning is chris frates, a reporter with politico, following this health care debate in the senate finance committee. they began their work at 10:00 a.m. eastern time. we will have live coverage of that here on c-span. walk us through what we will see today. guest: i think you will see exactly what the caller is talking about, the push for the public option. you will have both senator chuck schumer and jay rockefeller offering amendments to the max baucus bill that is being considered in that committee. and they are going to try to throw the public option into this bill, it is going to be an uphill battle -- the most conservative of the five congressional committees that has already considered this legislation. it is going to be very difficult for this public option
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plan to pass the senate finance committee and frank way on the floor. what charles schumer and rockefeller hope is by -- that they can build momentum, show there are democrats who want to get behind this. but when you have moderate members like blanche lincoln and mary landrieu and evan dabayh tt have misgivings -- it will be difficult for democrats to grouse all of them to vote in favor of the public option. what we will see today is the part one of the push for a public option among more liberal democratic members, and whether or not it translates into an amendment that passes is really a big question. host: what beyond the public option you expect to see in the markup? guest: we are still waiting to see senator nelson's amendment
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on medicare advantage. he hopes to grandfather in the seniors currently on the program, there are 10 million. he was to make sure those seniors will not lose any of the extra benefits they get under this program, things like dental care, i care, jim memberships. -- gym membership spirit a fight republican state of the democrats over amendments that push toward insuring seniors cannot lose benefits under medicare. democrats insist they will not lose benefits and that those kinds of amendments are not needed. the other area will be the messaging about the fees that max baucus has levied on insurance companies, pharmaceutical, missed a medical device and others in the industry to be able to pay for
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this bill. republicans are messaging those as new taxes that will be passed on to consumers. so you can expect to see amendments that will deal with that issue as well. what the republicans have staked out on the side of the market has been medicare -- that a cut benefits for seniors and raises taxes on consumers. host: what are you hearing from the committee and whether they will finish their work by this week? guest: xbox is one to finish by thursday or friday. -- max baucus wanted to finish it by thursday or friday. they are under some pressure to finish it. once the work is finished and the finance committee, it becomes senate majority leader harry reid's job to look of the bills that pass out of the
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committee and look at the health committee bill that already passed. he has to combine them into a piece of legislation that will pass the senate. that will take about a week because it needs to confer with the white house. and the chairman of the health committee. they need to work together to get it on the floor by the middle of october -- that is the sheet for a day -- shoot-for day for them to get on the floor. host: are you seeing signs of economic recovery? dennis from florida. caller: good morning, how are you. host: term that television down, all right? -- turned the television down. what are your thoughts?
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caller: i just wanted to make a comment, our corrupt capitalistic system. the only recovery occurring right now is for the large corporations. they cut their bottom line, cut their costs, starting to show profits. that is recovery. unfortunately with this capitalistic system, it is skewed toward corporations. people who make this country, the people will fight for this country, the people who die for this country, they don't receive benefits of a recovery until they go back to work. and until we see unemployment godown -- go down. but provoke the -- proverbial
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added, if my neighbor is not working -- if i am out, there is a recession. host: a couple of headlines. "the new york times." guantanamo deadline may be missed. remarks from the white house deflect challenges and shutting down the prison. here is a story in "the washington times" this morning that former alaska gov. sarah palin's memoir is to hit bookstores on november 17. it says she finished just four months after the bill was announced and released date has been moved up from spring until november 17. gov. palin has been unbelievably conscientious and investing in self deeply and passionately in this project. it said this, her first book, will be forwarded pages and the title "going wrote the: an american life -- "going rogue:
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an american life." go ahead, sir. caller: the fellow from newsweek hit the nail on the head is that the trouble with this country is that obama, he is playing right into their hands. that is the way they got his plan. a slow recovery with the higher echelon and business making their profits and their business, and trying to get the business flowing. they keep claiming the little business is the backbone. i am 86 years old and i remember what we got our benefit its was were big business, the steel companies when we had insurance and insurance -- i never had to pay a penny for any part of my health plan. and we recovered -- were covered, completely covered.
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the insurance companies eliminated that. now we are right down where they have control of all of the insurance plans. years ago i belonged to an insurance company, and i never had to pay a penny for anything i had done. host: jean, your thoughts from arkansas. caller: good morning. i do appreciate the discussion because it is and lightning. i am old enough, yet young enough, to have gone through at least two major recessions in our lifetime. what we are seeing now is what i seen before the starkly. it will come up a little bit and then it will nosedive down again, just like the guy and "the washington post" was talking about. people are getting over- positive. they still need to keep -- the
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adults polled in. government and the private sector and even maybe some of the major industries, we still need to watch it because it could go either in the tubes or out the roof. host: we have about 10 minutes in today's " washington journal." talking about signs of the economic recovery. let me put the phone numbers up on the screen. excuse me. let us go on to the next phone call, mesa, arizona. caller: am i on? yes. there is a bit of an economic
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recovery as far as the corporations are concerned, but not for the average citizen. they have us digging our own grave. before long we will be shocked and we will save that great depression that was somehow supposedly avoided because we are still digging a hole to the bottom, just not quite there yet. india and china -- that is where the money went to. they are recovering. it is time to help us in this country -- it is over with. we have had it. we are gone. host: wayne from westminster, maryland. democrats line. caller: i believe, much like the fellow earlier, basically what is happening is the country is hemorrhaging jobs still overseas.
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not planning on a level playing field for every product. we pay a health-care tax whereas in the rest of them, their health care is taken out through their taxes, we pay after taxes. therefore what we really need is to secure our industry by putting a single payer health care system in place. that will help us. the other thing right now with the iran situation, we are trying to -- i don't know, browbeat us again into another war against another sovereign nation on the pretense that they have weapons of mass destruction, just like in iraq. it is just one war after the
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other one. host: we will leave it there and move to scott from gainesville, ohio. what do you think of the economy? caller: i think it is in terrible shape. my wife manages a bank for a company that didn't get part of the bailout. i have been unemployed since april and i sent out well over 200 resumes and i am unemployed still as of today. i think it is terrible. as a matter of fact, my wife, like i say, she works for a bank, one of the major banks, the top 10 in the country. she had to take a 5% pay cut for several months and with me being unemployed, it has been awful.
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so i don't see it turning round. you know, everybody says with my being a nurse that there is a supposedly massive shortage. i would appreciate if somebody could call in and show me where it is. host: at a headline in "the wall street journal." fdic prepayment likely for banks. the federal deposit insurance corp. is expected to propose that the bulk of the banking industry prepay three years worth of fees to replenish the fund that insures trillion of dollars of customer deposits. it says that having banks pay up front for 2010, 2011, in 2012 could bring between $36 billion of to $54 billion to the government agencies, which insured deposits at more than a thousand banks. it cannot be learned when the assessments would have to be prepaid. a story in "the wall street journal" this morning.
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it is an event we will recovering here on c-span. you could go to our website, c- span.org, and watch it live on the web. next phone call, richmond, va., sean on the republican line. caller: i think we are basically at a bomb but it could drop off again. i have been on the employed for about 18 months. i have applied probably to 80 or 90 jobs. people don't want to hire. host: of what is your profession? caller: i was in sales. and frankly once the sales department downsize, they did not pick back up. as for looking at what we are doing, i would say we are kind of like addicts and we are going to methadone. we are not reforming the economy. we are not changing. wall street will get their bonuses. everybody wants to go back to the way the game was played. we are not reforming. host: would you like to see more
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focus from the of ministrations and congress on the economy and less on health care? caller: health care has to be addressed because they brought it up, but i think it is done in a manner which really does not address things. insurance companies, which no one talked about, takes 90 days up to 120 days to pay a physician. that is absurd. they cannot charge interest. medicaid and medicare, which everyone talks about as being a great thing, the reason why we can afford it at the price today is because we have a private insurance industry, which helps subsidize it because they pay physicians at a higher level. i think it is more complex. if you are president obama and you go to bethesda naval, you have a position that has sovereign immunity and cannot be sued but that cannot be allowed in the private sector. i think we need to address all facets. quite frankly, i think we are trying to go back to the old ways. it is sad.
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host: some have said that president obama, taking a trip to copenhagen to lobby for chicago to have the olympics in 2016 is a political risk. that if he fails and that lobbying effort, he will be criticized for spending his time doing something like that rather than focusing on health care and the economy. what do you think? caller: i think the president knows what already won this. i cannot think he will put his prestige on the line. it was probably in the back channels we have won this and he does want to go and say, look what i did for chicago. his wife was supposed to go. i believe don't care if he is going. this is a political move. he already knows. just like when my governor goes overseas and think -- thinks a deal for plants to come to the u.s., it has already been done. i would be dumbfounded and
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probably bet my colleagues for my kids that president of domino's chicago is getting this. host: and little bit more. his visit later this week will mark the first time a sitting u.s. president attempted to woo the ioc at the final meeting, where members vote on the winning city. >> phone call, omaha, nebraska. jeremy. caller: thank you for taking my call. i called in during the election last year and i would say we are seeing some signs of picking up in the economy, but again, i'm a type one diabetic and i had a job for four years. i took a chance to change jobs because my premiums were going up. i was paying 10 bucks an hour and i was paying $150 in health insurance per week, so i changed companies. but my health insurance was canceled a week after i changed jobs. so i might lose this job.
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basically what i am saying, i think the recession in part is due to health care. the reason americans are so crazy about it on both sides is that some people are totally happy with their health insurance but the people who don't have it are people with diseases like themselves -- i think we -- you know, i have gone without medicine for a week. i think they can fix the health care system because we are trying out here. for people who are against government intervention, i think that is what it is going to take to get the insurance companies. they offered me the cobra plan, and it was twice as much as what i was paying. host: let us hear from jim on the republican line from ohio. caller: how are you doing?
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host: are you seeing signs of recovery? caller: no, we are not. the only types of jobs are construction jobs, highways, things like that. all the manufacturing jobs have gone to china. we ought to make china pay for our health care since they have all of our jobs. another thing -- for seniors, the president is trying to get rid of these advantage plans, which is low income seniors need those. host: we are waiting for the senate finance committee to begin its work on the health care legislation. their fifth day of working on this bill. it should be getting underway momentarily but we will continue our conversation here on " washington journal" about whether or not we are seeing signs of economic

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